REMEDIES FOR TUBERCULOSIS.

Otago Daily Times, Issue 9093, 18 April 1891, Page 5 (Supplement)

REMEDIES FOR TUBERCULOSIS.

The Berlin correspondent of the Times, writing on February 25, says that on that evening Professor Liebreich, of the Pharmacelogical Institute, explained to a very large and eager meeting of the Berlin Medical Society, the nature of the anti-tuberculous remedy which lie has discovered, and which he claims in some respects to be a safer and more effective one than that of Dr Koch. To Mr John 0. Lendrum, a young English doctor at present residing here, I am indebted for the following summary of Professor Licbreich's lecture. Professor Liebreich began hia address by at onco stating that his remedy was derived from the animal kingdom, and did not belong to the class of bacterial poisons. He explained at the outset that his experiments were quite in their infancy, and that much further experience must be obtained before pronouncing a definite judgment on the method. The earlier part of the address was taken up with comparing the older and more modern methods of treatment of disease, and regret was expressed that the older methods had been so much neglected in favour of the newer ones. Professor Liebreich's attention had long ago been called to the effect that " Spanish fly " had upon many skin diseases, and in France especially much good work had been done with this preparation, not only in skin diseases, but also when given internally to tubercular cases. But the "Spanish fly," or Oantharis vesicatoria was almost entirely neglected as a method of internal treatment, owing to the fact that some varieties of the fly caused a greater reaction than others, owing to their containing a greater amount of the active principle cantharidin. But since that time the principle cantharidin had been obtained, and was found to be always of a definite strength. The question, therefore, that Professor Liebreich put to himself, was What was the peculiar action of cantharidin upon the organism? The effect of cantharidin was, as was well khown, when used externally upon the skin, to cause an exudation of serum under the epidermis, and when used internally to oause intestinal catarrh and renal inflammation. Experiments on animals

showed the lecturer that cantharidin had a peculiar action, exciting the transudation of serum alone, without cellular exudation from the capillary system, and that this occurred with more ease when the capillaries were irritated. He then argued that if a certain dose brought about this serous transudation from healthy capillaries, there could be got a dose which would affect only capillaries in an irritated state. To this end Professor Liebreioh made' experiments with cantharidate of potash. But next, he asked, what were we to infer from this transudation ? That serum had a definite influence upon bacterial action, acting as a local disinfestant; this, however, he must confess, was a pure hypothesis. He then went on to describe his experiments on the human subject. Oases were first taken from the Augusta Hospital, under Dr Ewald and Dr Heymann. Using a diluted solution of cantharidate of potash, ProfessorLiebreich injected an infinitesimally small dose, increasing this till finally he had used six decimilligrammes of the cantharidate. The cases selected, were those of tubercular laryngitis and pharyngitis, and all cases were improved by the treatment. However,' the question as to whether this method of treatment was a specific against tuberculosis he must regard as a secondary question, the primary one being as to the effect of the method—the semm method—on disease in general. The ordinary dose given was two decimilligrames of cantharidate solution. General and local reaction was almost entirely wanting, occasionally only a

little headache and faintness. The laryngeal cases showed a decided improvement, even after two or three injections.

On the transfusion of blood the Times' correspondent at Paris on February 25 writes:— " Members of the medical profession and the press were invited to-day to witness an experiment and demonstration by Dr Bernheim in his new system of curing

tuberculosis by transfasion of blood. The seance took place between 2 and 4 o'clock. The operation consisted in binding a goat firmly in the doctor's study, then an assistant cut the throat down to the carotid artery with a bistoury. This was the third time in the present month that the animal had gone through the same process. The last time two kilogrammes of blood were taken. Some hours later it was on its feet again and eating. The human subjects enter and present their bare arms to the operator, kneeling close to the table where the goat is lying. The patients, chiefly women and girls, have all been transfused already once or twice. As in ordinary bleeding, the patient's

arm i 3 tightly bandaged above the elbow. A small irj£i?ion is then made with a lancet* when the venous blood begins to flow. Then the assistant introduces into the insision a cannula ending in an indiarubber tube, a canula at the other end being fixed in the carotid artery of the goat. One minute and a-half suffices toiDJecfc 150 grammes of blood, meanwhile the patient converses calmly. The transfusion over, Dr Bernheim presented

eight patients to the audience whose cases | were almost desperate at the beginning of the treatment. Now their coughs are lessened, sleep and strength are returning, and their weight has increased. The most curious case was that of a washerwoman, tuberculous to a degree, with cavities in both lungs, when she first consulted Dr Bernheim. She has now lost the most distressing symptom, insomnia, and is able to follow her occupation for whole days. The doctor ended by declaring that he would not affirm the certain curability of tuberculosis, but was fall of hope. With i egard to the cure of the resnlt3 of hoamorrhage he was full of certainty. In an interview with Dr Bernheim before the operation, he was good enough to explain to me his views regarding the new method. He said:—.

"My object in giving a public illustration o£ my method is not so much to demonstrate its efficacy for the cure of tuberculosis as to prove that the operation known as the transfusion of blood, which is considered dangerous and is still prohibited by the law of France, involves no danger at all when performed under proper conditions. The only recorded case or death by transfusion of blood is that of Maury, which occurred in the seventeenth century. Maury died several days after undergoing the operation; but even in his case it was never clearly shown that the transfusion was the cause of death. The investigation into that case was inexact and incomplete, as such inquiries usually were in those days. The remedy is applicable not only to tuberculosis, _ but to many other maladies, as, for instance, htemorrhage consequent on childbirth, poisoning by noxious gases, smallpox, cholera, &c. The most important application of transfusion would be to cases of malarial poisoning, which are so frequent in our colonies. Transfusion is beneficial also in cases of haemorrhage o£ the lungs, the stomach, &c, in which surgery is absolutely powerless. " Another point which I shall hope to | elucidate by my experiments is the harmlessness of transfusing blood from an animal of one species into an animal of another species. At the present moment a strong prejudice exists against snch transfusion. It is believed that the red globules in the blood of a mammiferous animal are incapable of living in the veins of a mammiferous animal belonging to a different family. Now, I have myself been able to trace in the blood of a human subject the blood globules of a goat, which, being less than half the diameter of those of the human species, were easily distinguishable from the latter 15 days after the transfusion was performed. The goat is preferred for purposes of tranfusion as being the only domestic animal recognised by veterinary surgeons as not subject to tuberculosis. My medium for transfusion is a rubber tube composed of twopipes, which enables theblood to flow directly from the carotid artery of the animal, acting as a force pump, to the veins of the patient, acting as a suction pump. The injection of a clot is impossible, because should the blood congeal an interruption would immediately take place in the flow through the little tube which serves as the conductor. The progress of the operation can be always ascertained by the pulsations of the artery of the animal under the finger of the operator. As regards tuberculosis, the results have been signal, though not conclusive. The majority of my patients were in the last stage of the disease. I may confidently say, however, that even in oases which promised at first to baffle any kind of treatment whatever, the results achieved by my method have been such as my colleagues in the profession will be able to appreciate. Of the 22 tuberculosis subjects operated upon, three have been transfused for the third time, while no fewer than 70 patients have undergone transfusion at my hands."

—At a recant meeting of the Royal Botamo Sooioty in London the attention of the chairman waa called to a fruiting branch ofsimilax aspera, tha wild sarsapanlia of the Mediterranean coasts, a notable plant on account of its brilliant red berries, heart-shaped leaves and sharp clinging thorns, covering not only the stems but also the backs of the leaves, and has riven rise to the belief that it furnished the crown of thorns of Scripture.