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Valentine's Meat-Juice

In Diarrhoea, Dysentery and Cholera
Infantum where it is Essential to Con-
serve the Weakened Vital Forces with-
out Irritating the Digestive Organs,
Valentine's Meat-Juice demonstrates
its Ease of Assimilation and Power to
Sustain and Strengthen.

Dr. Simonyi Bela, Physician to the Israelite Hospital, Buda-Pest, Hungary: "I have tested VALENTINE'S MEAT-JUICE in the case of a child five years old who was much weakened by a severe and obstinate attack of Gastro-Enteritis, during which there was great difficulty in properly feeding him. Two days after he had begun taking VALENTINE'S MEAT-JUICE the extreme weakness began to abate and the patient recovered in a remarkably short time. I find VALENTINE'S MEAT-JUICE an excellent preparation, and in cases where a powerfully stimulating nourishment is needed it answers wonderfully."

For Sale by American and European Chemists and Druggists.

VALENTINE'S MEAT-JUICE CO.,
RICHMOND, VIRGINIA, U. S. A.

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The knowledge that a man can use is the only real knowledge; the only knowledge that has life and growth in it and converts itself into practical power. The rest hangs like dust about the brain, or dries like raindrops off the stones.-FROUDE.

useful have been brought forward by

The Medical World physicians. At a meeting of the Philadel

C. F. TAYLOR, M.D., Editor and Publisher.

A. L. RUSSELL, M.D., Associate Editors.

J. C. ROMMEL, M.D.,

E. S. TAYLOR, Business Manager.

Entered at the Philadelphia Postoffice as Second-Class Matter.

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"THE MEDICAL WORLD" 1520 Chestnut Street

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Philadelphia, Pa.

No, 7

The Doctor's Burden-Cancer. The Pennsylvania State Medical Society, in a commendable effort to overcome the enormous death rate from cancer, has, thru the great efforts of its Commission on Cancer, of which Dr. Jonathan M. Wainwright, of Scranton, Pa., is the hard-working chairman, started an active campaign against this dreaded disease thruout this country and enlisted the aid of many medical journals and practicians. We are pleased to present a few articles on that subject in this issue.

Considerable has been written about cancer and appeared in recent publications. Naturally a very prevalent disease would attract much attention and be discussed widely. Some things that are new and

phia County Medical Society on June 9th, Dr. Gordon J. Saxon detailed a number of experiments with diet and rat and mouse tumors. Using a modified Mendel-Osborne diet for some and a normal diet for other animals it was found that the MendelOsborne diet (consisting of pure gluten, pure starch, hog fat, and pure recrystallized lactose, with a mixture of salts-sodium hypophosfite, a magnesia salt, ferric sulfate, and sodium chlorid) had a controlling action over the tumors. Tumor formation was produced by inoculating the animals in the abdomen with sections of a tumor. This produced a tumor growth that in some instances was very large. Under the Mendel-Osborne diet some of the tumors retrogressed. When lactose was added to the diet the tumors grew rapidly. When cholesterol was added to the diet or administered hypodermically metastases occurred, which did not happen otherwise. and skatol also increased the growth of tumors. In some experiments a 2% solution of potassium iodid was also administered to stimulate thyroid secretion and the animals thus experimented upon promptly developed large tumors.

Indol

Bulkley1 advocates a vegetarian diet with the avoidance of coffee and alcohol in every form. Care must be taken that sufficient food is consumed to supply the necessary quantity of calories, and that it contains sufficient protein, carbohydrate and fat in a form and condition to be digested. Yet in the experiments of Saxon, mentioned above, lactose, a carbohydrate, increased tumor growth. Butter fat was found by the latter to accumulate in the body, but hog fat did not. Likewise commercial sugar of milk was found to contain a fattening substance that was absent from pure sugar of milk. We have found, however, in feeding experiments on the human that patients who ingest fat pork put on a layer of fat. Bulkley advises these patients

1 Medical Record, May 15, 1915.

to ingest a quarter pound of butter, representing 800 calories, each day.

Bulkley believes cancer is a biologic disease, a deviation from the normal life and action of certain of the ordinary cells of the tissues, which may be Cohnheim's embryonic cells or rests. He believes eating meat helps in the production of the disease. Likewise, constipation being an accompaniment of cancer, he concludes that the toxins produced by the millions of microorganisms generated thru intestinal stasis and fecal putrefaction are the real incidental cause of cancer, which is somewhat akin to Bell's view.

Bell' believes cancer is due to a chronically toxin-laden blood. This acting on the tissues for years distorts their physiologic processes to such an extent that the perversion of the cells leads them to the formation of a fungus, not bacterial in origin. He believes it possible to prevent cancer growth and to maintain the blood in a healthy condition by supplying it with food that has not been deprived by heat or other means of its vital principle. Faulty diet produces constipation, whereby toxins are absorbed into the blood stream, poisoning the tissue cells. When long continued, Bell believes cancer results.

Abelmann' is conducting experiments to determine whether or not cancer is an infectious disease and also to learn if cancer and sarcoma are merely two different manifestations of one disease. He is inoculating guinea pigs, chickens and rabbits with cancer and sarcoma tissue and reproducing the disease therein. His experimental work seems to be favoring his hypothesis.

Abelmann believes there is a difference in cancer-cell transplantation and cancer infection. When cells alone are transplanted they continue their growth at the point of inoculation and do not metastate. They are then distinctly a mushroom sort of parasitic growth, much like moss on a tree. In this instance the tissues of the animal themselves do not become cancer, but merely harbor the cancer cells growing upon them. This growth takes place immediately upon its being engrafted.

When a true cancer infection occurs, however, the specific micro-organism produces a cancerous state in the tissues of the animal, a tumor developing that is composed of the non-malignant cells of

1 Medical Record, June 5, 1915.

2 Illinois Medical Journal, February, 1915.

the host. In this condition metastasis occurs to various near and remote parts of the body. In Abelmann's experience, the infection takes a long period of time to develop the disease.

Certain of the animals experimented upon did not develop cancer, but instead pernicious anemia, leukemia and a condition simulating tuberculosis.

Saxon's experiments of inoculating rats also seem to show the infectious nature of the disease. Were it not so, would not the tumor material, when injected into the animals, follow the course of other foreign proteids, etc., and cause anaphylaxis, abscess, ulcer, etc.?

3

Erwin F. Smith, of the United States Department of Agriculture, says that so far as known all overgrowths on plants, such as galls and common knots on forest trees, are caused by parasites. The specific parasites capable of stimulating these overgrowths may be numerous and easily visible or few and hard to see. In terms of animal pathology, the growths resulting from their presence in plants may be classified either as granulomata or as true tumors, depending on whether the secondary overgrowths are the result of the direct migration of the parasite, which in its new location stimulates the surrounding tissues as it did in its former locations, or whether the cell of the plant itself is the primary migrant (whipped into abnormal multiplication under the stimulus of some intracellular parasite). In this second case, of course, the parasite is carried along to other parts of the tissue, where secondary tumors arise, but it does not move of its own accord. It is held like a prisoner within the multiplying cells of the host, and appears not elsewhere than in the original site of the disease except as it is carried from one part of the host plant to another part in the proliferating cells along with their growth, and then, of course, the secondary tumor must repeat the structure of the primary tumor. This type of plant disease is of interest because it simulates very closely what takes place in malignant animal tumors.

Crown-gall, according to Smith, behaves like cancer. It is produced by Bacterium tumefaciens. When a crown-gall appears upon a plant there occurs an enormous overgrowth of tissues, partly of the woody tissues, but the greater part consists of soft paren

3 "Proceedings of Seventeenth International Congress of Medicin," London, 1913.

chyma cells. Secondary tumors are formed by the outgrowth of strands of tumor cells, which destroy the surrounding tissue and extend toward the surface of the plant. True metastasis-the growth of secondary tumors at a distance, not connected structurally with the primary growth-has not been found in plants. This tumor disease has been reproduced in plants at least 2,000 times experimentally by Smith and every inoculation of a plant with the germ starts a tumor.' In endeavors to cultivate and experiment with the germs it was found that small quantities of acetic acid killed the bacteria. Similar results with acetic acid in foot-andmouth disease are reported in THE WORLD, April, 1915, page 143, by Page.

Smith inoculated fish with this organism and there resulted a growth resembling sarcoma. His view is that cancer is not a cell anarchy, but a cell symbiosis.

Packard also investigated plant tumors due to parasites. It may be, as we expressed in quoting Packard's investigations, that human beings spread such tumors by handling diseased plants.

The heredity theory finds a few followers. Green' states that from analysis of maps of cancer mortality and fuel consumed it is shown that where the cancer mortality is the highest coal is burned, and he believes that the composition of the coal has much to do with the causation of cancer. Orkney, where peat, containing a large percentage of sulfur, is burned, cancer is common. In those parts of France in which cancer is frequent the coal burned contains a large percentage of sulfur.

In

Smithies' says that the problem of the cure of gastric cancer is that of detecting malignant processes before there is an appreciable degree of perigastric lymphgland invasion. From the records of 700 gastric cancer cases he found retention of food for 6 to 12 hours, with variable color and rancidity. Free hydrochloric acid was present in 46%. Where lactic acid is present the disease is in a very advanced

1 For details concerning the parasitic nature of Bacterium tumefaciens see Bulletin 213, Bureau of Plant Industry, United States Department of Agriculture. (Sent on receipt of 40 cents by the Superintendent of Documents, Government Printing Office, Washington, D. C.) Also Bulletin 255, Bureau of Plant Industry, United States Department of Agriculture. (Sent on receipt of 50 cents by the Superintendent of Documents, Government Printing Office.)

2 Surgery, Gynecology and Obstetrics, February, 1913; MEDICAL WORLD, June, 1913, pages 223 and 224.

Moullin, Annals of Surgery, January, 1915. Edinburgh Medical Journal, January, 1915; Medical Record, May 8, 1915.

Illinois Medical Journal, February, 1915.

stage and operation is rarely successful. Occult blood was found in the feces in 72%. The glycyltryptophan test was positive in .40%. The Wolff test for soluble albumin was positive in 78.5%. The test gave a more positive finding than absence of acidity, the presence of lactic acid or positive glycyltryptophan test. It was approximately as constant a finding as tests for altered blood and the demonstration of motor insufficiency. It was not so constantly manifested as organisms of the Boas-Oppler type or increase in the formol index. In extragastric malignancy and in gastric syphilis the test was inconstant. In the differentiation between malignant and non-malignant achylias the Wolff test, when interpreted in connection with other clinical and laboratory data, proved of considerable value.

The Oppler-Boas bacilli were present in 94%, yeasts in 30%, sarcines in 10%. When Oppler-Boas bacilli are present hydrochloric acid is absent in more than 80% and an abdominal lump is detectible in three out of four cases.

The average hemoglobin percentage was 72. Red cells averaged 3,620,000 and leucocytes 11,200. In nineteen cases an excess of eosinophiles might have supported the contention of those who favor the parasitic etiology of cancer. The x-ray

does not show cancer until it has obtained some size.

Ambrose' says that a patient afflicted with a stomach trouble that does not respond to respond to proper medical or dietetic treatment within six weeks' time should be looked upon as suffering with an organic stomach lesion until proven otherwise.

Loeper and Buret endeavor to secure cancer cells by introducing into the empty stomach a quart of physiologic salt solution, massaging the stomach for a few moments and then removing the solution and centrifuging it. Microscopic examination may then reveal cancer cells.

McGrath' says that cancer in the prostate is usually insignificant in size, while metastases therefrom in bone is extensive. Similar relations have been observed with small cancerous nodules in the female breast and the thyroid. Manifestations in bone, with cause obscure, should direct attention to these observations. Involvement of lymphatic glands is not a dependable factor in diagnosis, since metastasis may be

1 Illinois Medical Journal, February, 1915.

2 Jour. Amer. Med. Assoc., September 19, 1914.

present in the skeletal structure and these glands be apparently unaffected.

Beebe treated a number of cases by means of a vegetable poultice and the. administration of certain of the remedies contained in the poultice. The poultice was composed of menyanthes trifoliata (water trefoil, buckbean), melilotus officinalis (yellow melilot, balsam-flower), mentha crispa (cross mint), brassica alba (white mustard), anemone hepatica (liverwort), viola tricolor (pansy), anthemis (chamomile), fructus colocynthidis (colocynth fruit), lignum quassiæ (quassia wood), urtica dioica (stinging nettle), radix rhei (rhubarb root), and hedge hyssop (gratiola officinalis). Experiments on animals by hypodermic injections of a solution of the material of the poultice showed an active local reaction, evidenced by swelling, redness, heat and tenderness. Then follows a leucocytosis, with relatively high lymphocytosis, some rise in temperature, and in human subjects a chill of varying intensity and duration. Under the microscope are found all the characteristics of a moderately acute inflammatory reaction with a relatively large leucocytic infiltration. When such extracts were injected directly into a transplantable rat sarcoma, the characteristic reaction followed and was accompanied by a peculiar necrosis of the tumor cells. When the skin over the tumor is ulcerated the affected area rapidly degenerates and a mass of necrotic tissue is discharged, followed by healing; while if the skin is not broken or ulcerated the reaction following the injection produced a marked infiltration of serum and leucocytes, particularly around the borders of the tumor, the tumor itself was gradually absorbed, and there was an apparent complete restoration of normal cellular conditions.

Beebe is now giving the remedy to his patients subcutaneously in the arm and securing results thereby.

Great care must be exercised in applying this poultice. It must be wrapped in gauze and the skin covered with a layer of petrolatum. The solution of the drugs for hypodermic use has been made by him in various ways. From 5 to 7 minims are injected every second day, the amount being judged by the patient's susceptibility. Nowell' has been using a carcinoma toxin and antitoxin. The toxin was derived from cancer tumors. This was injected

1 New York Medical Journal, May 15, 1915.

2 New England Medical Gazette, March, 1915.

into rabbits and the antitoxin formed in their blood has been injected by him into cancer patients, with success.

Retail Druggists and State Medical
Legislation.

The editor of this journal believes in law and order. He is not a dreamer, but he is an idealist in so far as ideals of the highest perfection should be conceived, in order to work toward them when they cannot be reached. reached. Humanity is very imperfect, and civilization is very imperfect. But both are better than they were formerly, and they are getting better all the time, with the exception of an occasional ebb in the flowing tide toward better things. However, perhaps it would be all ebb if some of us did not constantly strive to make things better.

A

The narcotic evil has long been with us. Remedies have long been considered. good place to start was in Congress, as a law made there would be nation-wide. Several bills were introduced, but the friends of narcotic legislation finally combined on the Harrison bill. This journal advocated narcotic legislation from the first, and did what it could to make the Harrison bill an efficient law.

Immediately after the Harrison bill became a law, last December, this journal sought to secure state narcotic legislation in harmony with the national legislation just achieved. About forty state legislatures met during the past winter, and many hundreds of letters went out from this office concerning narcotic legislation in the various states. All could not be achieved at once. That would have been beyond reasonable expectation. But good results were achieved in many states, and many bad bills were defeated. Few realize the importance of the latter. If a good law cannot be secured, the next best thing is to defeat bad bills.

I will here mention only two states. The Connecticut legislature was about to pass perhaps the worst bill from the standpoint of the medical profession that has been seriously proposed in any state, when I got in touch with affairs there. It was not narcotic legislation at all. It went much farther than narcotics. farther than narcotics. It provided that no one except a registered pharmacist could dispense any medicins whatever, in any amount nor for any purpose. would have reduced the physician's outfit to a prescription pad. A quick and vigorous

This

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