MEDICINE, ADVANCES IN. 



377 



as a specific for consumption. He gave a number 

 of theoretical reasons why the drug might be 

 expected to affect the tubercular diathesis favor- 

 ably, and then described several cases in which 

 he thought its administration had produced a 

 cure. 



Dr. S. V. Pearson publishes (Lancet, Nov. 22, 

 1902, p. 385) an account of 7 cases of chronic 

 tuberculosis which were treated with urea at the 

 Brompton Hospital for Consumption. Some of 

 the patients improved in general condition, but 

 none in physical signs; and in several an un- 

 doubted extension of the disease occurred. 



Dr. Pearson's conclusion was that " in chronic 

 pulmonary tuberculosis there is no special action 

 exerted by urea . . . either in arresting the rav- 

 ages of the disease or in counteracting the dele- 

 terious effect on the constitution." He, however, 

 states that it may have some value in other 

 forms of tuberculosis. 



The Dlazo- Reaction in Consumption. Dr. 

 Raoul de Boissiere, of the Victoria Hospital for 

 Consumption at Edinburgh, describes a series of 

 tests of the above reaction (British Medical Jour- 

 nal, Nov. 15, 1902, p. 1576). His conclusion is 

 that the reaction only occurs in a small number 

 of cases, usually only in those with fever, and in 

 association with an advanced stage of the dis- 

 ease. He agrees with previous observers in think- 

 ing the presence of the reaction indicates a bad 

 prognosis. 



Cancer. The year's study of the cancer prob- 

 lem has not produced any marked advance in 

 our knowledge regarding its causation or cure. 

 Cancer research has, however, been systematized 

 and largely extended, especially in England, and 

 definite results of the greatest importance will 

 undoubtedly follow the concerted attack, which 

 is now of world-wide proportions, on this mys- 

 terious scourge of the human race. 



A scheme has recently been elaborated in Eng- 

 land for the purpose of endowing cancer research 

 laboratories at the hospitals. A similar organ- 

 ization exists in Germany. In France coopera- 

 tive cancer work has been in operation for some 

 time, and a special journal is devoted to the pub- 

 lication of its results. In New York State, at Buf- 

 falo, there is a State-subsidized cancer laboratory. 



According to the report of the Cancer Com- 

 mission of the Harvard Medical School, which 

 was made possible by the Carolyn Brewer Croft 

 legacy, the work done in the past two years in 

 the study of the etiology of cancer has been 

 wliplly negative in its results, in the sense that 

 an increasing doubt has been thrown upon the 

 parasitic origin of the disease and upon the 

 pathological significance of so-called cell inclu- 

 sions. 



The director of the State Laboratory at Buf- 

 falo says, on the other hand, that the results 

 of the past year's work have been to strengthen 

 the conviction that cancer is infectious. 



Leopold, of Dresden, thinks " blastomycetes 

 may be the cause of malignant new growths in 

 man; they may convey the disease by inocula- 

 tion from man to animal, producing exactly sim- 

 ilar new growths which are fatal to the animals 

 affected." Among his experiments Leopold men- 

 tions the implantation into a rat of tissue from 

 a carcinoma of the ovary. The animal died in 

 sixty-one days from a tumor the size of a wal- 

 nut, which was found to be an adenosarcoma. 



Dr. Henry Morris, a leading London surgeon, 

 opened a discussion on cancer at the meeting of 

 the British Medical Association. He summed up 

 his conclusions regarding treatment in part as 

 follows: 



The serum treatment of malignant disease is 

 not of the slightest use in carcinoma. Not one- 

 half of the cases of spindle-celled sarcoma disap- 

 pear under treatment with Coley's fluid (see 

 last year's Annual on RECENT ADVANCES IN 

 MEDICINE for an account of the various modern 

 methods of treatment in which Coley's fluid is 

 described). This treatment has many dangers, 

 and should never be employed except in abso- 

 lutely inoperable cases. Beatson's treatment is 

 limited in its action to cases of mammary car- 

 cinoma, and even in these cases only a small 

 proportion are favorably influenced by it, and 

 it can be relied upon neither as a palliative or 

 cure in any given case. Rodent ulcer has in the 

 Finsen light and the X rays its most successful 

 treatment so far as we at present know. Sar- 

 coma, epithelioma, and other forms of carcinoma 

 are best treated, whenever possible, by early ex- 

 cision. With few exceptions the attempts to 

 cure cancer by means other than early and free 

 operations have hitherto been almost invariably 

 futile. 



The cases of wonderful cures of cancer by vari- 

 ous novel remedies which are continually ap- 

 pearing in the medical journals and newspapers 

 are probably, most of them, not cases of cancer 

 at all, but simply some benign form of tumor, 

 which to a cursory superficial examination may 

 present the characteristics of carcinoma. 



Serum Therapy. Typhoid Fever. Dr. A. 

 E. Wright, Professor of Pathology at the Army 

 Medical School, Netley (England), gives a de- 

 tailed account of the results thus far obtained 

 with the antityphoid serum (Lancet, Sept. 6, 

 1902, p. 651). His conclusions may be summed 

 up as follows: In almost every epidemic the use 

 of the serum has diminished the number of cases 

 at least twofold, and sometimes as much as 

 twenty-eight-fold. Superadded to the diminished 

 incidence a striking diminution of case mortality 

 occurs. " It may be taken that in the aggre- 

 gate the proportion of deaths to cases among the 

 inoculated is approximately half that among the 

 uninoculated." 



The combined effect of the diminished occur- 

 rence of the disease and the reduction of the 

 death-rate produce a total decrease of mortality, 

 which has often exceeded and seldom fallen below 

 75 per cent. There is, says Dr. Wright, a cer- 

 tain amount of risk in all protective inoculation. 

 (a) There is the case where the patient's resist- 

 ance is naturally low, or has been reduced, as is 

 often the case, by a previous attack of typhoid 

 fever. (6) Where a full dose is inoculated in 

 actually infected surroundings. (c) Where an 

 excessive dose is given or a normal dose too soon 

 repeated. 



It must be the task of the future to try to 

 minimize the risk, on the one hand, by working 

 out an adequate method of standardization of the 

 vaccine, and, on the other hand, of combining 

 with the study of the changes produced in the 

 blood by the antityphoid inoculation the study 

 of the blood in the typhoid convalescent and the 

 study of the gradual success or failure of the 

 process of immunization in the actual typhoid 

 attack. 



Another and less favorable view of the ty- 

 phoid antitoxin is presented in a report by Alex- 

 ander Crombie. As a result of statistics obtained 

 on 250 officers invalided from South Africa dur- 

 ing the Boer war he arrives at the following 

 conclusions: 



Up to the age of thirty years the advantage 

 of a single inoculation is distinct, the incidence 

 of the disease being 27 per cent., as against 51 



