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Totalitaristic Tissue Therapy
AMERICAN JOURNAL OF OPHTHALMOLOGY Published Monthly by the Ophthalmic Publishing Company EDITORIAL STAFF DERRICK VAIL, Editor-in-Chief
JAMES E. LEBENSOHN
LAWRENCE T. POST, Consulting Editor
DONALD J. LYLE
BERNARD BECKER
WILLIAM A. MANN
WILLIAM L. BENEDICT
P. ROBB MCDONALD
FREDERICK C. CORDES
FRANK W. NEWELL
SIR STEWART DUKE-ELDER
JOHN V. V. NICHOLLS
EDWIN B. DUNPHY
ALGERNON B. REESE
F. HERBERT HAESSLER
PHILLIPS THYGESON
700 North Michigan Avenue, Chicago 11
4010 West Madison Street, Chicago 24
640 South Kingshighway, Saint Louis 10
601 Union Trust Building, Cincinnati 2 30 North Michigan Avenue, Chicago 2
640 South Kingshighway, Saint Louis 10
1930 Chestnut Street, Philadelphia 3
100 First Avenue Building, Rochester, Minnesota
950 East 59th Street, Chicago 37
384 Post Street, San Francisco 8
1414 Drummond Street, Montreal
63 Harley Street, London, W.l
73 East 71st Street, New York 21
243 Charles Street, Boston 14
220 Meridian Road San Jose 26, California
561 North 15th Street, Milwaukee 3
PARKER HEATH
243 Charles Street, Boston 14
M. URIBE TRONCOSO
215 West 92nd Street, New York 25
S. RODMAN IRVINE
9730 Wilshire Boulevard, Beverly Hills, California
ALAN C. WOODS
Johns Hopkins Hospital, Baltimore 5
KATHERINE FERGUSON CHALKLEY, Manuscript Editor
Lake Geneva, Wisconsin Directors: WILLIAM L. BENEDICT, President; FREDERICK C. CORDES, Vice-President; WILLIAM A. MANN, Secretary and Treasurer; F. HERBERT HAESSLER, DERRICK VAIL, ALAN C. WOODS.
Address original papers, other scientific communications including correspondence, also books for review to Dr. Derrick Vail, 700 North Michigan Avenue, Chicago 11, Illinois; Society Proceedings to Mrs. Katherine F. Chalkley, Lake Geneva, Wisconsin. Manuscripts should be original copies, typed in double space, with wide margins. _ , Exchange copies of medical journals should be sent to Dr. F. Herbert Haessler, 561 North 15th Street, Milwaukee 3, Wisconsin. Subscriptions, application for single copies, notices of changes of address, and communications with reference to advertising should be addressed to the Manager of Subscriptions and Advertising, 664 North Michigan Avenue, Chicago 11, Illinois. Copy of advertisements must be sent to the manager by the 15th of the month preceding its appearance. Change of address notice should be received not later than the 15th of the month prior to the issue for which the change is to go into effect. Both old and new addresses should be given. Author's proofs should be corrected and returned within forty-eight hours to the Manuscript Editor, Mrs. Katherine F. Chalkley, Lake Geneva, Wisconsin. Twenty-five reprints of each article will be sup plied to the author without charge. Additional reprints may be obtained from the printer, the George Banta Publishing Company, 450-458 Ahnaip Street, Menasha, Wisconsin, if orderedat the time proofs are returned. But reprints to contain colored plates must be ordered when the article is accepted.
TOTALITARISTIC TISSUE
THERAPY
A n editorial in T H E JOURNAL (30:635, 1947) concluded with the following para graph :
tion. Politics and the State have no place in the premature exploitation of any medical discovery, regardless of the outcome.
The danger to science of replacing the mortar board by the pileus, the scarlet gown of the free doctor by the black shirt of Naziism or the red one of Communism, or by the star-studded hood of the necromancer, has been sadly demonstrated only too often in the past history of man's civiliza
W e a r e told that following the dissolution of Charles I's third Parliament in 1629 and until the Restoration in 1660, the suspension of freedom of discussion in the English uni versities, especially in Cambridge, produced
960
EDITORIAL a feeling of profound moral and intellectual depression. The mortar-board, a symbol of scholarship, especially that of master and doctor, was replaced, by orders of Cromwell, by a soft, brimless cap similar to the pileus of the ancient Greeks and Romans. As the devasting, dreary, and cruel days of the Puritans stretched out, forbidding freedom of expression and action, the pileus became the symbol of subservience to the State and no longer that of free scholarship. When the dreadful ordeal was over, the vice chancellor of Cambridge University, and doctors in scarlet gowns, the regents, nonregents, and bachelors with the hoods turned, and the scholars in mortar-boards (replacing the pi leus) celebrated the Restoration and the re turn of academic freedom on May 10, 1660, with appropriate and joyful ceremonies. This is only one example of many of the attempts of the State, in the past, to dictate the direction of men's minds, philosophies, and scientific actions. The memories of the Nazi dictation and direction of its physicians and scientists are still too fresh in our minds to be lightly forgotten, and what little we can gather from Communist Russia and her satellites indicates that the same thing is going on in those countries. As evidence of this, an article by Prof. Leslie G. Kilborn, "Medical education in Communist China," {Journal of Medical Education, 29:21, 1954) is most distress ingly illuminating and deserves careful em phasis. Dr. Kilborn was formerly dean of medi cine and director of the College of Medical Sciences in the West Union University, Chengtu, Szechwan, China. He had more than two years of experience under the new administration in China. He is convinced that very serious retrograde steps in China's health program are being taken. These steps involve three spheres: 1. The rejection of the traditional system of ethics which has governed the activities of the profession in most areas in which
961
scientific medicine has prevailed. 2. The repudiation of the scientific spirit, and the substitution for it of an authori tarianism characteristic of the prescientific era. 3. The enforced lowering of standards of medical education. It seems terribly urgent and important to include here some of Dr. Kilborn's discus sion of what he means by the repudiation of the Scientific Spirit in China. He says: It is generally agreed that the scientist acts in harmony with what has been called the scientific spirit. By definition this includes such components as honesty in observation and in reporting results, a critical attitude as opposed to the blind acceptance of authority and the complete objectivity in the evaluation of the work of others or of oneself.'All three of these components of the scientific spirit have now been condemned and discarded. Dr. Kilborn goes on later to say: The insistence by the authorities of the new regime in China upon the adoption of official views in thefieldof science has affected medical education very directly in at least two sciences other than genetics. The first to be involved was therapeutics. This became evident in 1950 and 1951, when much publicity was given to "tissue therapy," and its adop tion all over China was pushed by government agencies... . The rejection of the Scientific Spirit is shown, not so much in the claims for tissue therapy, although based upon seemingly in sufficiently controlled evidence, as in the in sistence by official bodies that tissue therapy be adopted. A nationwide chorus of praise for the new form of treatment was raised through Communist China, both in the popu lar press and in professional publications: Nobody dared criticize the published results even though few if any attempts had been made to con trol properly the conditions under which these had been obtained. Dr. Kilborn translates for us a report by Shao-Lung Ko, Tissue Therapy, Shanghai 1951, pages 694-695: The Ministry of Health of the East China Mili tary Commission held a conference on tissue therapy, consisting of 77 persons representing each province and municipality of the area. Included were adminis trative officers of health, specialists and clinicians.
CORRESPONDENCE
962
From August 15 to 20, 1951, they met for five days. On the final day of the conference, Vice Minister Chuen, of the East China Military Commission, re ported on the findings and clearly indicated the direc tion to be taken in the future by the East China Area (E. C. A.) in the promotion of tissue therapy. At this conference, the E. C. A. established a unified organization for the promotion of tissue therapy, namely the E.C.A. Tissue Therapy Promotion Com mittee. This committee is divided into the following five sections: theoretical, clinical, productional, ad ministrative and educational. From the reports made by the various representa tives at this conference regarding the results of tis sue therapy promotion in the E. C. A., tissue therapy is being practised in 31 municipalities and counties, including 84 clinical units. Over 7,000 patients have received tissue therapy; there are reports on 5,211 of these persons. The important results are as follows: These results are given in a table, which included 15 different diseases. The following six are typical: No DISEASE
CASES
1,077 Bronchial asthma Peptic ulcer 588 Corneal opacity 191 Optic atrophy 87 Retrobulbar neuritis 67 Corneal ulceration 49
o/r, SHnwiw, RESULTS
61.3 61.2 49.8 27.6 54.7 87.8
Ophthalmologists of wide clinical ex perience and with a suitable knowledge of ocular pathology will look with great, and proper, skepticism at the high percentages of favorable results of this treatment in the last four diseases mentioned, particularly in optic atrophy. The colloquial American ism, "Oh yeah?" seems to be a most suitable comment at this point. There is no room here to discuss further the subject of tissue therapy and "biogenic stimulators" in ophthalmology. There is at hand a good review by F. Deodati (L'Annee Therapeutique en Ophtalmologie, Paris, L'Expansion, 1950, v. 1, p. 105). It is perti nent, however, to cite two of this author's conclusions. He says: To judge by the Soviet literature, tissue therapy is really the "universal panacea," susceptible even of ameliorating chronic glaucoma, and even the healthy eye. (Sic) In comparing their statistics with those of the Anglosaxons, one is struck by the extreme diver gence of the results. Those (results) in the different statistics published by the French authors, who
seem to have been more numerous in utilizing tissue therapy, are equally far from being in agreement.
In other words, apparently Communism has no room for disagreement with the therapeutic fiat of the State. You either use the methods and get results dictated from above, or else Can this happen here? Derrick Vail. .
CORRESPONDENCE ACUTE OCULAR LIME BURNS
Editor, American Journal of Ophthalmology. In the February, 1954, issue of T H E AMERICAN JOURNAL OF OPHTHALMOLOGY,
I read an interesting article (page 209), on "Management of acute ocular lime burns," by Walter Z. Rundles, Jr., and James R. Quinn. It is an excellent work and I sincerely congratulate its authors. In the same issue (page 270) is a report by Dr. Philip M. Lewis who also treated (Case 3) a moder ately severe lime burn of the cornea and conjunctiva with cortisone. I wish to point to the fact that I have treated many accidents due to lime burns, using, as first aid, irrigations with a concen trate of cane sugar syrup. It transforms the calcium hydroxide into calcium gluconate, harmless, noncaustic, soluble, and easy to remove from the eye. I consider this little addition necessary. I have been using it successfully for a very long time at the Guadalajara Civil Hospital, at the Mexican Railroad Hospital, as well as in my own private practice. (Signed) Luis Martinez, Jr., M.D., University of Guadalajara, Guadalajara, Jal., Mexico.
JAMES E. LEBENSOHN
LAWRENCE T. POST, Consulting Editor
DONALD J. LYLE
BERNARD BECKER
WILLIAM A. MANN
WILLIAM L. BENEDICT
P. ROBB MCDONALD
FREDERICK C. CORDES
FRANK W. NEWELL
SIR STEWART DUKE-ELDER
JOHN V. V. NICHOLLS
EDWIN B. DUNPHY
ALGERNON B. REESE
F. HERBERT HAESSLER
PHILLIPS THYGESON
700 North Michigan Avenue, Chicago 11
4010 West Madison Street, Chicago 24
640 South Kingshighway, Saint Louis 10
601 Union Trust Building, Cincinnati 2 30 North Michigan Avenue, Chicago 2
640 South Kingshighway, Saint Louis 10
1930 Chestnut Street, Philadelphia 3
100 First Avenue Building, Rochester, Minnesota
950 East 59th Street, Chicago 37
384 Post Street, San Francisco 8
1414 Drummond Street, Montreal
63 Harley Street, London, W.l
73 East 71st Street, New York 21
243 Charles Street, Boston 14
220 Meridian Road San Jose 26, California
561 North 15th Street, Milwaukee 3
PARKER HEATH
243 Charles Street, Boston 14
M. URIBE TRONCOSO
215 West 92nd Street, New York 25
S. RODMAN IRVINE
9730 Wilshire Boulevard, Beverly Hills, California
ALAN C. WOODS
Johns Hopkins Hospital, Baltimore 5
KATHERINE FERGUSON CHALKLEY, Manuscript Editor
Lake Geneva, Wisconsin Directors: WILLIAM L. BENEDICT, President; FREDERICK C. CORDES, Vice-President; WILLIAM A. MANN, Secretary and Treasurer; F. HERBERT HAESSLER, DERRICK VAIL, ALAN C. WOODS.
Address original papers, other scientific communications including correspondence, also books for review to Dr. Derrick Vail, 700 North Michigan Avenue, Chicago 11, Illinois; Society Proceedings to Mrs. Katherine F. Chalkley, Lake Geneva, Wisconsin. Manuscripts should be original copies, typed in double space, with wide margins. _ , Exchange copies of medical journals should be sent to Dr. F. Herbert Haessler, 561 North 15th Street, Milwaukee 3, Wisconsin. Subscriptions, application for single copies, notices of changes of address, and communications with reference to advertising should be addressed to the Manager of Subscriptions and Advertising, 664 North Michigan Avenue, Chicago 11, Illinois. Copy of advertisements must be sent to the manager by the 15th of the month preceding its appearance. Change of address notice should be received not later than the 15th of the month prior to the issue for which the change is to go into effect. Both old and new addresses should be given. Author's proofs should be corrected and returned within forty-eight hours to the Manuscript Editor, Mrs. Katherine F. Chalkley, Lake Geneva, Wisconsin. Twenty-five reprints of each article will be sup plied to the author without charge. Additional reprints may be obtained from the printer, the George Banta Publishing Company, 450-458 Ahnaip Street, Menasha, Wisconsin, if orderedat the time proofs are returned. But reprints to contain colored plates must be ordered when the article is accepted.
TOTALITARISTIC TISSUE
THERAPY
A n editorial in T H E JOURNAL (30:635, 1947) concluded with the following para graph :
tion. Politics and the State have no place in the premature exploitation of any medical discovery, regardless of the outcome.
The danger to science of replacing the mortar board by the pileus, the scarlet gown of the free doctor by the black shirt of Naziism or the red one of Communism, or by the star-studded hood of the necromancer, has been sadly demonstrated only too often in the past history of man's civiliza
W e a r e told that following the dissolution of Charles I's third Parliament in 1629 and until the Restoration in 1660, the suspension of freedom of discussion in the English uni versities, especially in Cambridge, produced
960
EDITORIAL a feeling of profound moral and intellectual depression. The mortar-board, a symbol of scholarship, especially that of master and doctor, was replaced, by orders of Cromwell, by a soft, brimless cap similar to the pileus of the ancient Greeks and Romans. As the devasting, dreary, and cruel days of the Puritans stretched out, forbidding freedom of expression and action, the pileus became the symbol of subservience to the State and no longer that of free scholarship. When the dreadful ordeal was over, the vice chancellor of Cambridge University, and doctors in scarlet gowns, the regents, nonregents, and bachelors with the hoods turned, and the scholars in mortar-boards (replacing the pi leus) celebrated the Restoration and the re turn of academic freedom on May 10, 1660, with appropriate and joyful ceremonies. This is only one example of many of the attempts of the State, in the past, to dictate the direction of men's minds, philosophies, and scientific actions. The memories of the Nazi dictation and direction of its physicians and scientists are still too fresh in our minds to be lightly forgotten, and what little we can gather from Communist Russia and her satellites indicates that the same thing is going on in those countries. As evidence of this, an article by Prof. Leslie G. Kilborn, "Medical education in Communist China," {Journal of Medical Education, 29:21, 1954) is most distress ingly illuminating and deserves careful em phasis. Dr. Kilborn was formerly dean of medi cine and director of the College of Medical Sciences in the West Union University, Chengtu, Szechwan, China. He had more than two years of experience under the new administration in China. He is convinced that very serious retrograde steps in China's health program are being taken. These steps involve three spheres: 1. The rejection of the traditional system of ethics which has governed the activities of the profession in most areas in which
961
scientific medicine has prevailed. 2. The repudiation of the scientific spirit, and the substitution for it of an authori tarianism characteristic of the prescientific era. 3. The enforced lowering of standards of medical education. It seems terribly urgent and important to include here some of Dr. Kilborn's discus sion of what he means by the repudiation of the Scientific Spirit in China. He says: It is generally agreed that the scientist acts in harmony with what has been called the scientific spirit. By definition this includes such components as honesty in observation and in reporting results, a critical attitude as opposed to the blind acceptance of authority and the complete objectivity in the evaluation of the work of others or of oneself.'All three of these components of the scientific spirit have now been condemned and discarded. Dr. Kilborn goes on later to say: The insistence by the authorities of the new regime in China upon the adoption of official views in thefieldof science has affected medical education very directly in at least two sciences other than genetics. The first to be involved was therapeutics. This became evident in 1950 and 1951, when much publicity was given to "tissue therapy," and its adop tion all over China was pushed by government agencies... . The rejection of the Scientific Spirit is shown, not so much in the claims for tissue therapy, although based upon seemingly in sufficiently controlled evidence, as in the in sistence by official bodies that tissue therapy be adopted. A nationwide chorus of praise for the new form of treatment was raised through Communist China, both in the popu lar press and in professional publications: Nobody dared criticize the published results even though few if any attempts had been made to con trol properly the conditions under which these had been obtained. Dr. Kilborn translates for us a report by Shao-Lung Ko, Tissue Therapy, Shanghai 1951, pages 694-695: The Ministry of Health of the East China Mili tary Commission held a conference on tissue therapy, consisting of 77 persons representing each province and municipality of the area. Included were adminis trative officers of health, specialists and clinicians.
CORRESPONDENCE
962
From August 15 to 20, 1951, they met for five days. On the final day of the conference, Vice Minister Chuen, of the East China Military Commission, re ported on the findings and clearly indicated the direc tion to be taken in the future by the East China Area (E. C. A.) in the promotion of tissue therapy. At this conference, the E. C. A. established a unified organization for the promotion of tissue therapy, namely the E.C.A. Tissue Therapy Promotion Com mittee. This committee is divided into the following five sections: theoretical, clinical, productional, ad ministrative and educational. From the reports made by the various representa tives at this conference regarding the results of tis sue therapy promotion in the E. C. A., tissue therapy is being practised in 31 municipalities and counties, including 84 clinical units. Over 7,000 patients have received tissue therapy; there are reports on 5,211 of these persons. The important results are as follows: These results are given in a table, which included 15 different diseases. The following six are typical: No DISEASE
CASES
1,077 Bronchial asthma Peptic ulcer 588 Corneal opacity 191 Optic atrophy 87 Retrobulbar neuritis 67 Corneal ulceration 49
o/r, SHnwiw, RESULTS
61.3 61.2 49.8 27.6 54.7 87.8
Ophthalmologists of wide clinical ex perience and with a suitable knowledge of ocular pathology will look with great, and proper, skepticism at the high percentages of favorable results of this treatment in the last four diseases mentioned, particularly in optic atrophy. The colloquial American ism, "Oh yeah?" seems to be a most suitable comment at this point. There is no room here to discuss further the subject of tissue therapy and "biogenic stimulators" in ophthalmology. There is at hand a good review by F. Deodati (L'Annee Therapeutique en Ophtalmologie, Paris, L'Expansion, 1950, v. 1, p. 105). It is perti nent, however, to cite two of this author's conclusions. He says: To judge by the Soviet literature, tissue therapy is really the "universal panacea," susceptible even of ameliorating chronic glaucoma, and even the healthy eye. (Sic) In comparing their statistics with those of the Anglosaxons, one is struck by the extreme diver gence of the results. Those (results) in the different statistics published by the French authors, who
seem to have been more numerous in utilizing tissue therapy, are equally far from being in agreement.
In other words, apparently Communism has no room for disagreement with the therapeutic fiat of the State. You either use the methods and get results dictated from above, or else Can this happen here? Derrick Vail. .
CORRESPONDENCE ACUTE OCULAR LIME BURNS
Editor, American Journal of Ophthalmology. In the February, 1954, issue of T H E AMERICAN JOURNAL OF OPHTHALMOLOGY,
I read an interesting article (page 209), on "Management of acute ocular lime burns," by Walter Z. Rundles, Jr., and James R. Quinn. It is an excellent work and I sincerely congratulate its authors. In the same issue (page 270) is a report by Dr. Philip M. Lewis who also treated (Case 3) a moder ately severe lime burn of the cornea and conjunctiva with cortisone. I wish to point to the fact that I have treated many accidents due to lime burns, using, as first aid, irrigations with a concen trate of cane sugar syrup. It transforms the calcium hydroxide into calcium gluconate, harmless, noncaustic, soluble, and easy to remove from the eye. I consider this little addition necessary. I have been using it successfully for a very long time at the Guadalajara Civil Hospital, at the Mexican Railroad Hospital, as well as in my own private practice. (Signed) Luis Martinez, Jr., M.D., University of Guadalajara, Guadalajara, Jal., Mexico.