THE WHITE PLAGUE.

Gisborne Times, Volume XXIX, Issue 3266, 11 July 1911, Page 7

THE WHITE PLAGUE.

A NEW TREATMENT.

REMARKABLE RESULTS.,

(From ‘The Times,” May 26th.)

Before the Societe International de la Tuberculose and the Societe de la Therapentique, Paris, a paper was'read hy Dr. Samuel- Bernheim, president of the “Oeuvre de la Tuberculose Humaine,” the chief organisation for combatingtuberculosis by means of laboratories and dispensaries in Paris, and Dr. Louis Dieupart, physician-in-chief of the anti-tuberculosis dispensary of St. Denis. The paper gave remarkable information as to cures and improvements effected in a great number of/cases of pulmonary and other tuberculosis _by the administration of a preparation of radioactive menthol iodine. This antituberculosis specific was diie to the researches and the therapeutic experience of 1 * Dr. de Szendeffy, of Budapest, and for the past three years lias been practically. tested by Dr. Kertez Aba, of Budapest, and' -by a number of entirely independent specialists, including, in France, Dr. 'Herve, chief physician of the Sanatorium des Pins; Dr. Kaminsky and-Dr. Miachalovici, of Paris; Dr. Diamant Berger, assistant physician of the Rothschild Hospital, and Dr. Carle, chief physician of the Sanatorium of Taxil (Var). The composition of the preparation is as follows:

Peptonised iodine, .75 centigrammes; menthol, .06 centigrammes; radium barium chloride, the tenth of a drop in a solution of ether. EXPERIMENTS WITH lODINE. Dr. de Szendeffy had long been experimenting with injections of iodine in the treatment of tuberculosis, and when he communicated his results to his Paris colleagues they were keenly , interested, tut not surprised, as they had themselves obtained interesting results on the same lines.. The healing power of iodine is notorious, and it manifested itself in the .treatment of tuberculosis. There were concomitant effects, however, which rendered the employment of this agent almost impracticable, such as the nearly intolerable paid! which followed the injections and the specific symptoms of “ioclism” in the patient. The new preparation of radio-active menthol iodine is open to none of these drawbacks, and its therapeutic action is. extremely remarkable, if not completely explicable. The experiments on animals, particularly guinea pigs, gave the residt of complete immunisation after the injection after the injection of bacilli, which otherwise proved fatal. When experiments upon human subjects were carefully initiated the results were entirely and surprisingly successful. One cubic centimetre was injected daily thirty times in succession. In no case did the system manifest any intolerance of the injection, as was constantly the case in the treatment by iodine. In pulmonary tuberculosis there was a distinct improvement after ten injections. Blood spitting ceased, as did all the other distressing accompaniments of phthisis, such as night sweats, emaciation, absence of appetite, and weakness. The patients increased in weight and strength, and the physical improvement was attended by most important results in improved psychological conditions — a return of confidence and courage which' is half the battle in dealing with this terrible disease. Seventy-five cases are fully reported by Dr. Bernheim and Dr. Dieupart. and they include a remarkable case of tuberculosis epididymitis, four cases of tuberculosis of the borne, two cases of adenitis, and two cases of tuberculous laryngitis, which is usually fatal- The improvement .continues while the patients follow their usual occupations, and it is seen fiom the details that many of them belong to the working classes, and that some of them are engaged in employments which subject them to very unfavorable influences. Especially remarkable ore the records of the treatment of lupus. The scleresis in these cases seemed to follow a uatiiral course, and the healing process was of the same character as that which is observed in what miedht fie called benign cases of tuberculosis, where fresh air and sunshine effect a cure. 1 EFFECT OF THE NEW TREAT- . MENT.

In tuberculosis association of the.Koch bacillus with other microbes is generally a bad prognostic. The streptococcus and staphylococcus appear to increase the poisonous secretion of" the bacillus. The radio active mentihol iodine very rapidly destroys the streptococcus. In one case none Avere observed after three days’ treatment. In the laboratory the bacilli rapidly proA r e recalcitrant to the dying process, and ultimately disappear altogether. The authors of the paper, which is to be read before the two Paris medical societies, declare that in their belief “Dr de Szendeffy lhas made a most rm-. portant discovery for the cure of tuberculosis;'” .and that “his remedy is really the complete remedy of Avhich he speaks in his researches.” It is. they are convinced, a remedy “which is inoffensive, which always acts, and Avhicih cares in a very great number of cases.” The authors of the paper conclude: “We have seen, studied, observed, noted, and we are resolute .partisans of the radio active menthol iodine, because this therapeutic agent has given us immediate results and unhoped for cures. Dr. de Szendeffy and his collaborators have the great merit of only producing this remedy after they had acquired the certainty of its efficacy and of its action.” ? , BRITISH MEDICAL OPINION. The account in “The Times” naturally excited great interest among the members of the medical profession. It was the general subject of discussion in the hospitals and although some scepticism was expressed as to the claim which is put forward by Dr. Bernheim and Dr. Dieupart that the -new preparatibn is a '.‘complete remedy”, there was a disposition to await further information before forming any. definite conclusion. THE USE OF INJECTIONS.

The first attempts to treat tuberculosis conditions by the injection into the body of remedies destructive to the bacillus, either by their direct operation or by virtue of changes Avhich they produce in the condition or activities of the blood, Avere those of the late Professor Koch, who, in 1890. introduced the preparation Avhich . he _ called “tuberculin” as an agent for this purpose. It unfortunately happened-that the announcements made with regard to: the efficacy of this preparation were somewhat premature; "and, in the early experiments, it Avas administered in larger doses than subsequent experience Avas found to justify, with the result that it fell greatly into disrepute, and that further research concerning its properties Avas much retarded.

OIR ALMROTH WRIGHT’S METHOD Sir Ahnroth Wriglit discovered that an injection into the blood of killed bacterial cuiltnres greatly increased the aower of the person so operated' x'pon to destroy living bacteria of the same

species; and he has traced-this increase of power to an increase, produced by the action of the injected material, in the absolute quantity of the anti-bacterial substances always present in the .blood, but not always present in sufficient amount to overpower, an unexpected invasion. Hie described the chief antibacterial agent as an “opsonin,” and devised a means of ascertaining, by what he called the “opsonic index,” at. least an approximatipn to knowledge of the resisting power of any given patient at a given time. Guided by this knowledge, he has for some years been successfully treating a large number" of cases of tuberculosis affecting various parts of the body by injections of killed cultures of the tubercle bacillus; liis work in: this direction having been mainly surgical, and concerned with tubei-culosis of joints, >of glands, and of the skin, rather than with the form chiefly affecting the lungs, to which, however, the principles involved are equally applicable. In a general way it may be said that the tubercle bacilli invading a'joint, for example, are more or less imprisoned within certain boundaries, from which they have little tendency to escape during quiescence of the affected part, but from which they may be released so as to enter the general blood-stream by active or-passive movements. The, principle adopted by Sir Almroth has been to administer _a. dose of killed bacilli sufficient to raise the “opsonic index,” or measure of .the killing power of the blood, to a sufficient extent, and then to move the affected joint sufficiently to liberate, and to throw into the general blood-stream a certain proportion of the living bacilli, there to meet their fate. This process, repeated with the necessary frequency and at the proper intervals, would in time kill all the bacilli concerned/ and leave the patient in a condition, to recover. The method is indeed only a. utilisation of the natural methods of defence, increased and systematised by art; and it is being carried on: with regard not only to tubercle, but also with regard to many other diseases, and with regard to the various bacilli, productive of pain, inflammation and suppuration, tlie streptococci and staphylococci, which complicate many other diseases, and not least among them cancer • As far as can be judged from the, reports already received, the action of the “radio-active menthol iodine” will be different from that of the killed “cultures” employed by Sir Almroth Wright, and the drug will itself poison and kill the bacilli in the circulation instead of merely stimulating the blood to do so. If this be so, the principle concerned seems to be that underlying the value of “606” in syphilis, rather than that underlying the protective influence of the various forms of “vaccination,” the general term under which, although cows are no longer the sources of the material employed, the application of bacterial cultures is now commonly expressed. The researches of Sir Almroth Wright rendered the work of Jenner intelligible, and established the principle on which it rests.

CRITICISM BY A HOSPITAL PHYSICIAN.

A senior physician to one of the principal chest hospitals in London expressed himself to a representative of “The Times” as being, on the.information already presented, very sceptical of the new treatment. His views were fully endorsed by one of the leading pharmaceutical chemists of London. Referring to the composition of the new preparation, he said : Peptonised iodine is unknown and quite impossible; iodine in combination with an albuminous base is known and in use at the present time. It is- conceivable that this might be digested or “peptonised,” and thus a combination of iodine with a peptone be produced. But this is not “peptonised iodine.” The internal administration of iodine —that is, iodine as a metal and l not in combination as iodides—is also well known. But its administration by the subcutaneous method lias been practically impossible. It is conceivable, hqwever, that a combination of iodine wjtli a peptone could be so administered and that the pain of the injection could be diminished by the use of menthol. Radium barium chloride is unknown. But there is a barium chloride “method” <ff separating radium from uranium cres. and l possibly a radium salt so extracted may be thus referred to. A radium salt so .extracted can be obtained at a price of 15s per gramme, but anything which can really be relied upon would cost quite £2O for a milligramme. My scepticism is based on the following points: —Many separate new methods are- involved in what has hitherto been published,, none of which are necessarily concerned with tuberculosis; the subcutaneous administration of iodine; the use of peptonised iodine: and the use of a radio-active body' subcutaneously. Why have these methods not been disclosed as tbe researches proceeded ? Why have all the steps been delayed publication until the special application to pulmonary tuberculosis had been discovered ? Why was the radioactivity -method not tried for cancer, in which disease the effect of radium is now under investigation ? Why is the announcement made in Paris, when the discovery was made in Hungary? -