MEDICINE, RECENT ADVANCES IN. 



358 



city, has also had considerable success with it, 

 and has recently reported two remarkable cures. 



Dr. William B. Coley, surgeon to the New York 

 Cancer Hospital, experimented in LS!)2 with in- 

 jections into cancer of the mixed poisons result- 

 ing from the growth of the streptococcus of ery- 

 sipelas and the Bacillus prodigiosus. Although 

 the treatment is somewhat dangerous, Dr. Coley's 

 statistics show that about 12 per cent, of the 

 cases are fairly successful, and its trial is cer- 

 tainly warranted when other means have failed. 

 Regarding the use of the cancer sera, or anti- 

 toxins, statistics collected by R. Eschweiler, of 

 Bonn, indicate that they have little if any value. 

 The effect of the passage of an electric current 

 through the diseased tissue has also been tried, 

 but with little success. An electrolytic method, 

 using a mercury-coated electrode introduced into 

 the substance of the cancer, is believed by Dr. 

 Coley to warrant further trial. The X-rays and 

 Finsen's light apparatus have been tried some- 

 what extensively in the last year or two. The 

 latter has proved very valuable in a variety of 

 cancerous growth known as rodent ulcer, and Dr. 

 Malcolm Morris, of St. Mary's Hospital, London, 

 has reported positive cures. Other investigators 

 have also announced some success with it, al- 

 though it has not been so successful in other va- 

 rieties of cancer. 



The X-rays have seemed to possess a curative 

 action in some cases. Dr. Carl Beck, at a recent 

 meeting of the German- Medical Society of New 

 York, showed a case of melano-sarcoma, one of 

 the most malignant forms of the disease, which 

 had been markedly improved by X-ray treatment. 



The cause of cancer is still an unsettled ques- 

 tion, physicians and pathologists differing radi- 

 cally regarding its origin. There are four general 

 theories the embryonal of Cohnheim, which sup- 

 poses the affected tissue to have either contained 

 an isolated portion of embryonal tissue which sud- 

 denly becomes active, begins to grow, and forms 

 the cancer, or through some change in condi- 

 tion, the tissue itself suddenly assumes embryonal 

 qualities. The parasitic theory attributes it to a 

 specific germ, a cancer bacterium. The dietetic 

 ascribes it to high living; and the irritation the- 

 ory supposes it to be due to long-continued irri- 

 tation, as from constantly holding a clay pipe in 

 the mouth, or from bruises or abrasions. Of 

 these, the embryonal and the parasitic have the 

 most supporters. 



Several physicians among them Dr. Roswell 

 Park, of the New York State Pathological Lab- 

 oratory at Buffalo, Dr. H. G. Plimmer, of St. 

 Mary's Hospital, London, several investigators 

 on the Continent Sanfelice, of Cagliari, Roncali, 

 of Rome, and Durante have isolated organisms 

 from cancer-cells which they believe to be the 

 true cause of cancer. In the English Practitioner 

 for April, 1899, Dr. Plimmer published several 

 plates showing these cancer germs. Dr. Park 

 says of the work at the 1 Pathological Institute in 

 Buffalo: "In virtually every case of cancer y.et 

 examined, where we have had access to the fresh 

 specimen, it has been possible to find bodies which 

 can not be other than parasites, . . . and they 

 can now be demonstrated to any one at the lab- 

 oratory." In an address before the American Medi- 

 cal Association at St. Paul, June 5, 1901, he said 

 they had been able to cause cancer hi animals by 

 inoculating them with cancerous material from 

 the human subject. He also called attention to 

 the fact that independent investigations by Pfeif- 

 fer, Sawtschenko, Sjobring, Eisen, and Max 

 Schiller have corroborated in detail the results 

 attained at the Buffalo Institute. 

 VOL. XLI. 23 A 



Regarding the increase of < ; ni< > ,,', , t \t which 

 considerable has recently been ~ ;i o. < ;,, : ,. j J,I HO 

 much difference of opinion unionjj , i< i;ms. 

 The majority, perhaps, believe 1h;if I|M ,. j llls ),.,, 

 a considerable increase in its pr<:\;< 



Dr. William Whitney, at the i> > < n i 



meeting of the Massachusetts Medic;. 

 quoted statistics from large hospital-;, i 

 asylums, etc., which indicated that theic I,,.- 

 not been an increase. Nothnagel found, from ;i 

 study of the statistics at the K. K. Allgeiiieinei 

 Krankenhaus, Vienna, that there had been no 

 appreciable increase in its prevalence. 



It is contended by some physicians that the 

 large and apparently continued increase which 

 most statistics appear to show is due simply to 

 improved methods of diagnosis, which now cor- 

 rectly label as cancer many cases which a few 

 years ago would have escaped detection. 



One of the recent and novel theories to ac- 

 count for cancer interesting probably chiefly be- 

 cause of its novelty is put forward by Dr. John 

 Holden Webb, of Melbourne. He believes cancer 

 to be due to the precipitation from solution of 

 cholesterin, a wax-like constituent of bile. This 

 is normally held in solution by a natural soap. 

 When for any reason this soap is not present, 

 cholesterin is deposited and a cancer-cell formation 

 is started. So Dr. Webb's remedy for cancer is 

 soap solution, subcutaneously injected. He claims 

 to have successfully treated cancer in this way. 



Another novel suggestion has been made re- 

 cently by F. Loefrler. He calls attention to ob- 

 servations by the older clinicians showing that 

 the supervention of a malarial infection can cause 

 the disappearance of cancerous growths, points 

 out that the disease is rare in the tropics where 

 malaria abounds, and urges experimental work 

 with injections of the malarial organism. 



Bovine and Human Tuberculosis. The an- 

 nouncement by Dr. Robert Koch at the tubercu- 

 losis congress held in London in the past summer 

 that bovine and human tuberculosis were two 

 different diseases, and that the human disease 

 could not be produced in cattle, was not by any 

 means a novel theory, several other students hav- 

 ing previously announced a similar view. But the 

 fact that Dr. Koch himself was the discoverer of 

 the tubercle bacillus, and that his researches had 

 been chiefly instrumental in building up the elab- 

 orate precautions now in force against tubercur 

 lous cattle, and their meat and milk, gave his 

 statements an unusual interest. The experiments 

 on which he based his views were briefly as fol- 

 low: Six young cattle were fed with tubercular 

 sputum almost daily for seven or eight months; 

 four repeatedly inhaled great quantities of bacilli 

 that were distributed in water and scattered with 

 it in the form of spray. In other cases, the 

 tubercle bacilli or the sputum was injected under 

 the skin or into the abdominal cavity. None of 

 these cattle (there were nineteen^ showed any 

 symptoms of the disease, and they gained con- 

 siderably in weight. From six to eight months 

 after the beginning of the experiment they were 

 killed, and not a trace of tuberculosis was found 

 in their internal organs. When these same ex- 

 periments were repeated with tubercle bacilli 

 from tuberculous cattle, the animals invariably 

 became tuberculous. 



As has since been pointed out by several writers, 

 even if cattle are immune to human tuberculosis, 

 man might be susceptible to the bovine form of 

 bacillus, and, as Dr. Koch himself said, the direct 

 experimental test of this question, involving as it 

 would the deliberate infection of human beings, 

 is at present impossible. 



