352 



MEDICINE, RECENT ADVANCES IN. 



rence of the bite. Dr. Calmette was himself re- 

 cently bitten by one of the poisonous snakes in 

 his laboratory, and probably saved his life by 

 the immediate use of antivenine, although he ul- 

 timately lost the finger that was bitten, through 

 gangrene. 



Among other sera that have been tried, but as 

 yet not sufficiently to furnish very definite in- 

 formation regarding their value, are an antistrep- 

 tococcic serum which has been used in the treat- 

 ment of pernicious anaemia, in septicaemia (blood- 

 poisoning), and in puerperal fever, and an anti- 

 tetanic serum used in tetanus (lockjaw). 



The Differentiation of Human and Other 

 Mammalian Blood. In the Deutsche Medici- 

 nische YVochenschrift of Feb. 7, 1901, Dr. Uhlen- 

 huth describes a method of distinguishing be- 

 tween the blood of man and the common warm- 

 blooded animals. The possibility of a reliable test 

 of this sort is of the utmost medico-legal impor- 

 tance. The method is described by Dr. Uhlenhuth 

 as follows: At intervals of six to eight days about 

 ten cubic centimeters of defibrinated human blood 

 are injected into the abdominal cavity of a rabbit. 

 After five such injections the blood-serum of the 

 rabbit is fit for use. Samples of the blood of dif- 

 ferent animals are diluted with about 100 times 

 as much ordinary water, making pale-red solu- 

 tions of an equal depth of color, which are then 

 filtered. Two cubic centimeters from each of these 

 solutions are placed in separate test-tubes, and 

 each mixed with 2 cubic centimeters of a solution 

 of common salt, of a strength of 1.6 per cent. It 

 is essential to use this particular salt solution, for 

 the normal serum of the rabbit mixed with plain 

 water gives rise to a turbidity that may interfere 

 with the test. Dr. Uhlenhuth employed in his 

 experiments the blood of man, the ox, horse, ass, 

 pig, sheep, dog, cat, stag, fallow deer, hare, guinea- 

 pig, rat, mouse, rabbit, common fowl, goose, tur- 

 key-cock, and pigeon. To each of the prepared 

 test-tubes are now added 6 or 8 drops of the 

 serum of the rabbit that has been injected with 

 human blood. In the test-tube containing the 

 solution made with human blood appears a dis- 

 tinct turbidity, which finally leads to the deposit 

 of a copious flocculent precipitate; while the con- 

 tents of the tubes containing solutions of the 

 blood of the other animals remain perfectly clear. 

 The reaction is very delicate, only traces of blood 

 being required. Dr. Uhlenhuth succeeded in rec- 

 ognizing specimens of human blood that had been 

 allowed to dry on a board for four weeks. His 

 experiments were carried on at the Hygienic Insti- 

 tute of the University of Greifswald. 



Spinal Anesthesia. Leonard Corning, an 

 American physician, is said to have first suggested 

 the direct injection of drugs into the spinal canal, 

 for the production of local anesthesia without 

 affecting the brain. Bier, in 1899, first tried the 

 method in actual practise, and it has since been 

 used extensively, especially on the Continent. The 

 method of procedure is described by Tuffier, of 

 Paris, as follows: An ordinary hypodermic syr- 

 inge is used, with a long needle. The patient is 

 seated and bent slightly forward. The needle is 

 now carefully inserted just above or below the 

 spinous process of the fourth lumbar vertebra. 

 As soon as it enters the medullary canal the 

 clear, yellowish cerebro-spinal fluid begins to 

 escape drop by drop. The hypodermic syringe is 

 now screwed to the needle, and from 15 to 30 

 drops of a dilute solution of one of the local 

 anesthetics cocaine, eucaine, or tropacocaine 

 are slowly injected. The needle is then with- 

 drawn, and the small puncture is closed with col- 

 lodion. The anesthesia passes gradually upward 



from the feet to a height corresponding to the 

 distribution of the highest affected spinal nerves. 



The subject of spinal anesthesia is still in an 

 unsettled condition, some observers praising it 

 highly and others finding it dangerous and ineffi- 

 cient. Tuffier has performed more than 200 opera- 

 tions under it, and thinks it very valuable. 

 Baker, of University College, London, also speaks 

 highly of its value. Bier, who has used it con- 

 siderably, does not encourage its general adop- 

 tion. Delbet concludes that it offers no advan- 

 tages over chloroform. Some surgeons prefer co- 

 caine, others eucaine, and Dr. Schwarz has found 

 that tropacocaine, in doses of 0.015 gram to 0.050 

 gram, gives the best results. 



The method has been used in many cases where 

 a general anesthetic was contraindicated, owing 

 to heart or kidney disease, and its chief field of 

 usefulness wall probably be found in such cases. 

 An attempt has also recently been made to pro- 

 duce neuro-regional anesthesia by injecting co- 

 caine into the large nerve trunks. 



Cancer. The present methods of treating can- 

 cer may be roughly divided as follow: opera- 

 tion, drugs, bacteriatherapy, organotherapy, 

 phototherapy, antitoxins, and electricity. In bac- 

 teriatherapy (Coley's method) another germ, or 

 germ toxin, is injected into the cancer, on the 

 theory that it will act as a poison to the cancer 

 microbe. In organotherapy (Beatson's method), 

 certain glands are removed, or the secretions of 

 others are supplied to the body, on the theory that 

 cancer is due to some perversion of glandular 

 function. 



By far the best results in the treatment of 

 cancer are obtained through early and extensive 

 operation. It is of the utmost importance that 

 the extirpation be done as early as possible. For 

 this reason every abnormal growth in the shape 

 of a suspicious lump or " sore " should be imme- 

 diately examined by a physician, and, if there is 

 any doubt regarding its benignity, instantly cut 

 out. There is no doubt that thousands of persons 

 die horrible deaths every year who might have 

 been saved for many years of usefulness if the 

 surgeon had been called in early enough. The 

 other methods of treating cancer are usually only 

 adopted as a last resort, in cases upon which, 

 either owing to the large extent of the disease or 

 its inoperable situation, the surgeon is helpless, 

 or else when the patient absolutely refuses opera- 

 tion. 



The local application of caustic drugs is the 

 regulation method of the numerous advertisers 

 of cancer cures " without use of the knife." It is 

 sometimes successful in the superficial forms of 

 the disease. The injection of various irritating 

 substances has also been tried, among them oil 

 of turpentine, arsenious acid, acetic acid, alco- 

 hol, methyl violet, the venom of the cobra-di- 

 capello, and CJielidonium ma jus (celandine). The 

 latter drug, which is sometimes given internally, 

 is much used in Asia and the East Indies for the w 

 treatment of warts and tumors; and according' 

 to Dr. William B. Coley, of the New York Cancer 

 Hospital, it undoubtedly has some influence on 

 cancerous growths. The internal administration 

 of drugs has met with little success. 



Dr. George T. Beatson, of the Glasgow Cancer 

 Hospital, is the originator of a method of treat- 

 ment that has met with some success, especially 

 in cancer of the breast. It consists of the re- 

 moval of the ovaries by operation, and the sub- 

 sequent administration, in some cases, of extract 

 of thyroid gland. Stanley Boyd reports success 

 in 35 per cent, of the cases so treated. Dr. Robert 

 Abbe, surgeon to St. Luke's Hospital, New York 



