4gg The Philippine Journal of Science 1923 



On the basis of this evidence Docherty and Burgess conclude: 

 From the above it is quite evident that the anthelmintic, in the quantities 



mentioned, produced lesions in the liver in two cases, as Smillie anticipated; 



on this account it seems inadvisable to prescribe even a 5 c.cm. dose with 



We feel compelled to disagree radically with the above con- 

 clusion. We are not convinced that the drug produced the 

 lesions described by Docherty and Burgess. Leucocytic infil- 

 tration, so far as we are aware, is not produced by drug intoxica- 

 tion. Leucocytic infiltration of the liver is to be seen in a 

 fairly large proportion of natives of the Tropics and is possibly 

 the expression of a more or less inactive infectious process in 

 the intestine. It is to be noted that Major Callender reports 

 it among his observations on one preparation. The only sig- 

 nificant thing we can see in Docherty and Burgess's report is the 

 finding recorded as "fatty degeneration of liver cells," but even 

 there evidence is lacking in support of the statement that it 

 was caused by carbon tetrachloride. It appears from the 

 record of this case, however, that this man's bowels did not 

 move for the first twenty-four hours after he took his first dose 

 of 5 cubic centimeters of the drug. The drug was administered 

 at 8 a. m. Two hours later he complained of dizziness and nau- 

 sea and immediately vomited the cathartic (salts) that had been 

 given him at 4 p. m. The second installment of the treatment 

 apparently gave him no discomfort. We add these facts simply 

 to make the record complete, and not because we believe that 

 the retention of the drug worked the man any real damage. 

 Two men in our own series went for nearly twenty-four hours 

 after treatment without a bowel movement, at the end of which 

 time we gave them salts. They showed no untoward symptoms. 



The chemical structure of carbon tetrachloride and chloro- 

 form, and what we know of the pharmacology of the two sub- 

 stances, give ground for the belief that their action upon the 

 organism, when absorbed in harmful quantities, may be very 

 similar. The action of chloroform upon the liver is too well 

 known to require discussion here, but a review of the anatomy 

 of this organ makes it clear that the location of lesions in the 

 liver with reference to the anatomical structure has a distinct 

 importance in considering the genesis of liver pathology. The 

 report of Docherty and Burgess states that fatty degeneration 

 was present, but omits a description of the character and loca- 

 ' tion of the lesions, so it is impossible for us to satisfy ourselves 

 that the fatty change was due to carbon tetrachloride and not 



