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THE EXPECTATION OF LIFE AFTER A RECOVERY FROM AN EMPYEMA.
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. "
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. "