- Email: [email protected]
SCARLET FEVER, SMALL-POX, AND COW-POX.
1291
(dated Dec. 21st, 1887).—14th Middlesex (Inns of Court) : Acting Surgeon T. W. C. Jones to be Surgeon (dated Dec. 21st, 1887).—1st Volunteer Battalion, the Prince Albert’s (Somersetshire Light Infantry) :-John Maurice Harper, Gent., to be Acting Surgeon (dated Dec. 21st, 1887). - list Volunteer Battalion, the South Staffordshire Regiment : Surgeon H. H. Smith, from the 1st Volunteer Battalion, the Worcestershire Regiment, to be Surgeon (dated Dec. 21st, 1887).
Correspondence. "Audi
alteram partem."
SCARLET FEVER, SMALL-POX, AND COW-POX. To the Editors of THE LANCET. SIRS,—In your issue of Dec. 17th you give an abstract of Dr. Klein’s paper, read at the Epidemiological Society, on " Some of the Infectious Diseases common to Man and the Lower Animals," and also an abstract of Professor Crookshank’s investigation into the so-called Hendon cow-disease and its relation to scarlet fever in man. With your permission, I would like to make a few remarks on some of the points referred to in these papers, as they are of some im-
portance. The first is with regard to the relation of human variola and cow-pox. The popular notion in this country is that cow-pox is merely small-pox modified by its passage through the cow, and Dr. Klein brings forward this notion in support of his contention that the mysterious cow disease at Hendon was scarlatina, or, at any rate, produced that malady in people who partook of the milk of the affected cattle. Now, I have for years, in your columns and elsewhere, maintained that human variola and vaccinia are not the same disease, but are quite distinct, and cannot by any known means be translormed. I still maintain this, in the face of the assertions that Ceely, Badcock, and one or two others, have succeeded in converting small-pox into cow-pox; and if Dr. Klein relies upon these to establish his position with regard to an eruptive mammary disease of cows giving rise to scarlet fever in mankind, then I am afraid he stands upon very shaky ground. As Dr. Klein himself acknowledges, he utterly failed to effect the transformation of small-pox into cow-pox, even when acting under the direction of Mr. Ceely, and experimenting under the most favourable conditions on more than thirty milch cows and heifers. And I will make bold to say that if Dr. Klein carries on experiments all his life in this direction he will be unsuccessful, as have several continental commissions (not alone the French commission under Chauveau), and every individual-myself among the number,-except the three or four above mentioned. Clinically and anatomically they differ widely, and their points of similarity are few and trivial. All attempts to convert variola into vaccinia by inoculating cows with small-pox matter have failed-have failed in the hands of careful and most able experimentalists, and they will fail. But in this case we can resort to our heart’s content to experiments upon our own species to prove whether the two maladies are due to one virus-a course which we can so seldom adopt with regard to other diseases. We can inoculate human beings with vaccine virus with the view of transforming vaccinia into variola, and if the latter is the former the results in every case should not be doubtful. Transferred to its original soil, the virus should be itself again, and produce small-pox with all its well-marked features. Since the days of Jenner countless millions of persons have been subjected to this experiment, if we may so designate every-day vaccination ; and I ask if there is an instance on record in which vaccinia became variola? I certainly know of none. Surely it is as reasonable-if not more so-to attempt to convert vaccinia into variola as to transform the latter into cow-pox. Compare the ease with which vaccinia can be transmitted from calf to calf, from the latter to the child, and vice versd, throughout endless generations, and without the slightest tendency to become variola, with the very few recorded cases of supposed production, experimentally, of the disease from small-pox virus, which was for ever changed by implantation in the body of the cow.
The virus of cow-pox and that of
small-pox differs
in
no
respect from the viruses of other contagious diseases in regard to preserving its specific potency. The viruses of anthrax, tuberculosis, glanders, rabies, scarlatina, measles, &c., will always produce none other but these diseases, and if the symptoms produced by them when inoculated in other species of creatures than those to which they are native are somewhat different, yet when carried back to their original
soil they are again the same in everything. I am quite astonished at the way medical men in this country have treated this question of identity of cow-pox and smallpox, and accepted the assertion as to this identity without
resorting to proof. With regard to the
existence of scarlatina in cows, or a disease in them which will give rise to that malady in people through ingestion of milk, I am seriously inclined todoubt it. The disorders of cows have been closely studied of late years by veterinary surgeons, and nothing resembling scarlet fever has been observed. Scarlet fever in man, if derived from the cow, would also be that disorder in the bovine. I should not like to be considered dogmatic in the matter, but I think it will eventually be found that a mistake has been made as to this Hendon disease, and that Professor Crookshank is on the right track. We shall then have to express regret that such a panic should have been caused and such serious injury should have been done to a most important industry through over-anxiety and haste to protect the public from a dreaded scourge. With regard to Professor Crookshank’s statement that veterinary surgeons he inquired of informed him that the disease he saw affecting the cows’ udders was very well known to them, but was not described in text-books of veterinary medicine, I may mention that in my work on " Veterinary Sanitary Science and Police," published twelve years ago, in the section on Variolous Disease in Animals, I particularly described cow-pox and the diseases of the. udder with which it might be confounded. Cow-pox and horse-pox are not at all rare diseases. I am, Sirs, yours truly, GEORGE FLEMING, Dec. 21st, 1887. Principal Veterinary Surgeon of the Army.
THE TREATMENT OF CANCER. To the Editors of THE LANCET. SIRS,—Mr. Jennings, in your number of the 17the, asks me to give him an answer to several questions : In what sense do I use the term " cure," and whether I believe Dr. Smith’s case1 was one of cure, with non-recurrence for nineteen I answer: I would accept a case of cancer as having been cured that fulfilled the following conditions: that after the removal of the cancer, by whatever mode of treatment
years ?
adopted-remedies, external or internal,-there being also> evidence of complete restoration to health, the patient remained without any reappearance of the disease throughout the remainder of life- throughout a life in which death ultimately took place from causes common to the break-down.. from ordinary wear and tear, of natural structures. I cannot therefore accept Dr. A. F. Smith’s case as a " cure," deeply valuable as it may be as an instance of prolonged immunity from recurrence, and confirming, in selected cases, the extreme value of the knife. In what sense do I speak of cancer infiltrating textures around its origin"? Well, I always speak of a cancer as almost always infiltrating th& part
or
tissue it
attacks, the natural character of the
struc-
being either absorbed or otherwise destroyed and replaced by new material. The clinical recognition of,£ adjacent glandular contamination is surely so obvious that I may be pardoned for not offering on the present occasion any description of its features. I am, Sirs, yours faithfully, tures
Birmingham,
OLIVER PEMBERTON.
Dec. 20th, 1887.
To the Editors
of
THE LANCET.
SIRS,—Like many others, I have tried Chian turpentines and, though not regarding it as a specific, have still been very much impressed by its effects in two or three cases of undoubted cancer. An old lady, the subject of cancer of the cervix, took the turpentine for one or two months. 1
THE LANCET, 1887, vol. ii., p. 565.
(dated Dec. 21st, 1887).—14th Middlesex (Inns of Court) : Acting Surgeon T. W. C. Jones to be Surgeon (dated Dec. 21st, 1887).—1st Volunteer Battalion, the Prince Albert’s (Somersetshire Light Infantry) :-John Maurice Harper, Gent., to be Acting Surgeon (dated Dec. 21st, 1887). - list Volunteer Battalion, the South Staffordshire Regiment : Surgeon H. H. Smith, from the 1st Volunteer Battalion, the Worcestershire Regiment, to be Surgeon (dated Dec. 21st, 1887).
Correspondence. "Audi
alteram partem."
SCARLET FEVER, SMALL-POX, AND COW-POX. To the Editors of THE LANCET. SIRS,—In your issue of Dec. 17th you give an abstract of Dr. Klein’s paper, read at the Epidemiological Society, on " Some of the Infectious Diseases common to Man and the Lower Animals," and also an abstract of Professor Crookshank’s investigation into the so-called Hendon cow-disease and its relation to scarlet fever in man. With your permission, I would like to make a few remarks on some of the points referred to in these papers, as they are of some im-
portance. The first is with regard to the relation of human variola and cow-pox. The popular notion in this country is that cow-pox is merely small-pox modified by its passage through the cow, and Dr. Klein brings forward this notion in support of his contention that the mysterious cow disease at Hendon was scarlatina, or, at any rate, produced that malady in people who partook of the milk of the affected cattle. Now, I have for years, in your columns and elsewhere, maintained that human variola and vaccinia are not the same disease, but are quite distinct, and cannot by any known means be translormed. I still maintain this, in the face of the assertions that Ceely, Badcock, and one or two others, have succeeded in converting small-pox into cow-pox; and if Dr. Klein relies upon these to establish his position with regard to an eruptive mammary disease of cows giving rise to scarlet fever in mankind, then I am afraid he stands upon very shaky ground. As Dr. Klein himself acknowledges, he utterly failed to effect the transformation of small-pox into cow-pox, even when acting under the direction of Mr. Ceely, and experimenting under the most favourable conditions on more than thirty milch cows and heifers. And I will make bold to say that if Dr. Klein carries on experiments all his life in this direction he will be unsuccessful, as have several continental commissions (not alone the French commission under Chauveau), and every individual-myself among the number,-except the three or four above mentioned. Clinically and anatomically they differ widely, and their points of similarity are few and trivial. All attempts to convert variola into vaccinia by inoculating cows with small-pox matter have failed-have failed in the hands of careful and most able experimentalists, and they will fail. But in this case we can resort to our heart’s content to experiments upon our own species to prove whether the two maladies are due to one virus-a course which we can so seldom adopt with regard to other diseases. We can inoculate human beings with vaccine virus with the view of transforming vaccinia into variola, and if the latter is the former the results in every case should not be doubtful. Transferred to its original soil, the virus should be itself again, and produce small-pox with all its well-marked features. Since the days of Jenner countless millions of persons have been subjected to this experiment, if we may so designate every-day vaccination ; and I ask if there is an instance on record in which vaccinia became variola? I certainly know of none. Surely it is as reasonable-if not more so-to attempt to convert vaccinia into variola as to transform the latter into cow-pox. Compare the ease with which vaccinia can be transmitted from calf to calf, from the latter to the child, and vice versd, throughout endless generations, and without the slightest tendency to become variola, with the very few recorded cases of supposed production, experimentally, of the disease from small-pox virus, which was for ever changed by implantation in the body of the cow.
The virus of cow-pox and that of
small-pox differs
in
no
respect from the viruses of other contagious diseases in regard to preserving its specific potency. The viruses of anthrax, tuberculosis, glanders, rabies, scarlatina, measles, &c., will always produce none other but these diseases, and if the symptoms produced by them when inoculated in other species of creatures than those to which they are native are somewhat different, yet when carried back to their original
soil they are again the same in everything. I am quite astonished at the way medical men in this country have treated this question of identity of cow-pox and smallpox, and accepted the assertion as to this identity without
resorting to proof. With regard to the
existence of scarlatina in cows, or a disease in them which will give rise to that malady in people through ingestion of milk, I am seriously inclined todoubt it. The disorders of cows have been closely studied of late years by veterinary surgeons, and nothing resembling scarlet fever has been observed. Scarlet fever in man, if derived from the cow, would also be that disorder in the bovine. I should not like to be considered dogmatic in the matter, but I think it will eventually be found that a mistake has been made as to this Hendon disease, and that Professor Crookshank is on the right track. We shall then have to express regret that such a panic should have been caused and such serious injury should have been done to a most important industry through over-anxiety and haste to protect the public from a dreaded scourge. With regard to Professor Crookshank’s statement that veterinary surgeons he inquired of informed him that the disease he saw affecting the cows’ udders was very well known to them, but was not described in text-books of veterinary medicine, I may mention that in my work on " Veterinary Sanitary Science and Police," published twelve years ago, in the section on Variolous Disease in Animals, I particularly described cow-pox and the diseases of the. udder with which it might be confounded. Cow-pox and horse-pox are not at all rare diseases. I am, Sirs, yours truly, GEORGE FLEMING, Dec. 21st, 1887. Principal Veterinary Surgeon of the Army.
THE TREATMENT OF CANCER. To the Editors of THE LANCET. SIRS,—Mr. Jennings, in your number of the 17the, asks me to give him an answer to several questions : In what sense do I use the term " cure," and whether I believe Dr. Smith’s case1 was one of cure, with non-recurrence for nineteen I answer: I would accept a case of cancer as having been cured that fulfilled the following conditions: that after the removal of the cancer, by whatever mode of treatment
years ?
adopted-remedies, external or internal,-there being also> evidence of complete restoration to health, the patient remained without any reappearance of the disease throughout the remainder of life- throughout a life in which death ultimately took place from causes common to the break-down.. from ordinary wear and tear, of natural structures. I cannot therefore accept Dr. A. F. Smith’s case as a " cure," deeply valuable as it may be as an instance of prolonged immunity from recurrence, and confirming, in selected cases, the extreme value of the knife. In what sense do I speak of cancer infiltrating textures around its origin"? Well, I always speak of a cancer as almost always infiltrating th& part
or
tissue it
attacks, the natural character of the
struc-
being either absorbed or otherwise destroyed and replaced by new material. The clinical recognition of,£ adjacent glandular contamination is surely so obvious that I may be pardoned for not offering on the present occasion any description of its features. I am, Sirs, yours faithfully, tures
Birmingham,
OLIVER PEMBERTON.
Dec. 20th, 1887.
To the Editors
of
THE LANCET.
SIRS,—Like many others, I have tried Chian turpentines and, though not regarding it as a specific, have still been very much impressed by its effects in two or three cases of undoubted cancer. An old lady, the subject of cancer of the cervix, took the turpentine for one or two months. 1
THE LANCET, 1887, vol. ii., p. 565.