Alleged Cure for Leprosy. Dr. Starr's Suggestive History of Antitoxin

Progress, Volume IV, Issue 1, 2 November 1908, Page 28

Alleged Cure for Leprosy. Dr. Starr's Suggestive History of Antitoxin

Quite tlie, pleasantest story told for some years in any newspaper was told late in September in the columns of every newspaper of the Dominion. It went round the country with a smile touching all hearts, telling of the cure of a young Maori leper at the dismal station on Quail Island, the quarantine station of Port Lyttelton. He had according to that account been placed there hopeless, left in a hut to face alone the dreadful nightmare, life in death, which is the lot of the incurable leper cast forth from the bosom of his family for the protection of society. It was this class of suffering that enriched the history of mankind with the sublime story of Damien. A truly noble story of self-sacrifice which will appeal to the best feelings of mankind till the end of time. But in that story there is no hope of anything better on this side of the Great Divide. This story from the quarantine ground lacks the essential great element of tlie epic of Molokai, but it has what the other had not : an element of hope here below, an actual return to life, honour, friends, father, mother, brethren. It is told of a speciality of treatment, of the gradual return of health, of the final cure, and the happy release. With cheerful humour he who had been restored to life inscribed "to let" on the walls of his dismal abode where he had expected to die the death of the lingering helpless; he sang and shouted as he marched down to the boat; he disappeared among men restored to brightness, strength, and the joy of young life. The story went on to tell of the famous Dr. Deycke who had, while in charge of a. leper home near Constantinople, found the antitoxin of leprosy, and effected cures, establishing the work on a business footing so that the remedy could be got by all and sundry at regular depots, for the asking. In this way had the Department of Health of the Dominion acquired the needful, and in this way had this pleasant story come about. Later on it was said that the cure had not been so great after all, that the patient had not been really badly afflicted, that, in fact, he had not been under treatment for some time before he left the island. It is hard to tell. There are persons who will carp at anything and everything. This will have to be cleared up. At any rate there are, whatever may be the case here, many very wonderful cures in once hopeless diseases. Medicine, since the middle of the last century, has become a science of wonderful discovery. It looks like making up for lost time, for during the whole of the centuries preceding the above date medical science made what practically may be called

no discoveries in the proper sense of the term. Harvey had discovered the circulation of the blood — whether prompted thereto by hints let fall by the unfortunate Servetus a couple of centuries before his time matters little. But what were the properties of the blood circulating no one began to suspect until the days when microbes began to appear on the face of the earth. ' ' In those days, ' ' the future historian of the Faculty will say, "there were found among the children of men strange creatures, small of stature, gigantic in deadly power, expert in war against life, and they lived on the pith of men, vitiating their blood. The earth was covered of them as of thick darkness, and the cry of the afflicted rose up to heaven as a song of mourning that ceaseth not during any hour of the day or night. At certain seasons multitudes perished, and there were none left to bury the slain. The captains of industry looked on in silence more bitter than words, and the faces of the men of the ancient tribes of Galen and Aesculapius were perturbed even as those of the disciples of Jenner the great, Harvey. called the ingenious, of the master Cagliostro. and, indeed, of all the mighty captains of both healing and quackery." Such was the world for all the ages before the revelation of the microbe Then medical science took the unseen world in hand, with expressed intention of curing every microbe-carried disease under the sun. The intention has not vet been carried out, but enough has been done to prove that the date of complete fulfilment is very much nearer than was generally supposed when the intention was first proclaimed Bui if completion is not vet, it must be admitted that very much that is interesting has been done. Of all the stories told that make up the sum of this vast interest, no one is more interesting than the description of the myriads of creatures that enter the blood of man and fight there with obstinate fury for his life. The subject, which is intensely fascinating, is suggested by a brilliant and at the same time very solid article in Harper's

(July number for the current year), from the pen of Dr. M. Allen Starr. Why, he asks at the outset, do certain diseases seem to make their victims immune from further attacks? No answer, he declares, was ever made until the studies of the blood were begun, after which it was found that infectious diseases are due to the presence in the blood of organisms which in their growth produce effects which we see as disease "Just as we can obtain the perfume of n flower by dissolving; it in alcohol," so each organism of disease appears to give off a substance which we call a toxin, which is dissolved in the blood just as the perfume is dissolved in alcohol. It is this toxin in the blood which causes disturbance in the organs of the body, and the body goes to work at once to cast it off or to counteract its effects. By some mysterious activity in the body, the actual site of which is still uncertain, there is pro duced in the blood a substance which exactly counteracts the toxin It is as if we killed the perfume of one extract by mixing it with another And when enough of this substance which is called an anti-toxin has been produced by nature in the blood, the effects of the original toxin subside and health returns. But if the body is too weak to produce sufficient anti-toxin the person dies." But the manufacture of anti-toxin does not cease with the recovery. It goes on. with the result that the supply of anti-toxin in the blood grows and grows until there is enough to prevent injury from toxin for a considerable period. In other words, the garrison goes on increasmg until it renehes a strength that makes any successful assault of the enemy impossible The storming columns are simply devoured as they enter the blood. ITenr-p one seldom hears of measles attacking any one a second time, though cases are not unknown; enough to show that the best arrangements of even our well-disposed friends among the microbes "gang agley" sometimes. Smallpox and other diseases are in the same boat. Having discovered so much, science determined to go further. If anti-toxin is made by nature with success against a certain percentage of disease, why not set up an artificial process by which enough antitoxin might be made against every infectious disease in sufficient quantity to wipe it entirely off the list of things fatal ? On this quest science embarked with tre mendous enthusiasm. So very enthusiastic did some experimenters become that they actually announced the discovery of toxin or microbe of old age, with the probability of the speedy discovery of the proper antitoxin. The Anti-toxin of Old Age ! It required no reflection to enable one to see that this meant the immortality of the human race. Visions arose in the minds of the sanguine — the kind of people who furnish the means of livelihood for wild cats — of a great and growing literature devoted to the question of how long this overcrowded planet could go on finding sustenance for deathless mankind, increasing by millions upon millions. These visions have faded away. Many things, however, happened during the fifteen years that have elapsed. Whether they include the incarceration in a mental hospital of the idiot who "discovered" the microbe of old age, we cannot say The only thing we know on that point is that if not there he ought to be. The list of things achieved is, nevertheless, large and imposing, and decidedly encouraging. They have been fifteen years of experiment and

patient investigation in laboratories, ringing the changes on all the questions proper to the subject. "How to isolate the organism? How to secure the toxin? How to prevent too great an effect? How to separate the anti-toxin from the blood? How to prepare it for use?" These questions all involved the investigation of vital processes carried on by nature in the bodies of living animals. At the outset it was found that different animals reacted differently to different organisms. It is impossible to obtain an antitoxin for diphtheria from the blood of dogs or cats or monkeys. But from that of the horse it can be separated. And tests had to be made before a safe dose could be used upon man. All these details have been worked out, and now there are obtainable anti-toxins for tetanus or lockjaw, for an-

thrax or malignant pustule, for typhoid fever, for cholera, for the bubonic plague, and for several other types of infection. These anti-toxins, if used early in the disease, are "most efficacious," and even when used late are "of service." Here are some examples: In diphtheria. — New York 1893 (before anti-toxin), there were 6468 cases in the hospitals, with a mortality of 1962, or 34 per cent. ; in 1906 (after antitoxin), the cases were 7441, with a mortality of 731, or 9 per cent. In London, 1894, the eases were 3666, with 1035 fatalities; in 1901 the cases were 7622, and 849. ' ' Taking the cases the world over, ' ' says Dr. Starr, ' ' it may be stated that the mortality from diphtheria has been reduced from 35 per cent, to 9 per cent. ' ' Every year, it will be realised by a simple calculation, many thousands of lives of children are saved which under the old state of things would have perished indubitably. The name most prominently associated with this discovery is Behring, and his name will go down to posterity as famous as Jenner's. Another famous name is Fleckner's. He made his discovery in the treatment of that dreadful disease cerebro-spinal meningitis. The victim lies plunged in fever, unconscious, paralysed. Till the present century there was no cure, no relief, no hope but in the action of nature, and nature acted only in twenty-one per cent, of the cases, leaving the other seventy-nine to pass out like the dying of a candle in the socket. How the anti-toxin was found is a fairy tale of scientific determination and perseverance. The microbe did not attack the blood. It had a fancy for the oily fluid supplied to the nervous system for its protection from the bones. In his den in that hidden lair of the human system the tiger

of the microbe world defied capture, even approach. But they got on to his track, followed up the "spoor" patiently, and made a capture at last. Having separated it from the fluid surrounding, the question arose about growing a supply of anti-toxin from his remains. The animal creation had to be explored for the answer to this question, and rapidly science worked to the two which offer favourable breeding ground — the monkey and the horse. And the anti-toxin was secured. More than that, a factory for its regular manufacture was set up. Then arose another difficulty. Wasserman prepared the antitoxin in Koch's famous laboratory in Berlin, and it was injected in the usual way, i.e., into the blood. But it failed, the creature would not live in the blood. "Where avouW he consent to live and move and have his being for service against the toxin pest ? That question Fleckner answered in a flash of inspiration. He injected the anti-toxin into the cavity of the spine, pitching right upon the country occupied by the enemy, with the result that very soon cures began to be effected where before the assault on the stronghold of the enemy there was not the ghost of a hope. "It is necessary,'' says Dr. Starr, "to puncture the spine with a hollow needle, to draw away some of the oily fluid, and to throw into the spine the anti-toxin through the needle and leave it there to do its work. The earlier this is done in the disease the better." This cure is not as perfect as is desirable yet, for the difficulties are great, but the fatalities are reduced to twenty-nine per cent., a gain of 50 per cent, on the old style. The discovery of Fleckner is barely a year old, having been hit upon in 1907. In 1906 there were in the City of New York some 1020 seizures, of which 812 were fatal.

"Which means that within a year from the discovery and application of the anti-toxin no less than 500 were saved out of every 1000 attacked, who would otherwise have died. Who has not heard of the awful visitations of cholera in India, of the bubonic plague in the East, of the visitations of typhoid in the cantonments of the Indian armies of Britain? But, owing to these discoveries in the microbe world, typhoid is no longer dreaded by the authorities responsible for the wellbeing of masses of troops in a malarious climate, and "it is thought that both cholera and plague are under control. ' ' The last is a large order, and in sight of the terrible array of fatalities chronicled every month from India, with their annual aggregate running well into the millions, the size appears very great indeed. But where such a fine beginning has been made there is good ground for hoping for more and better results. Lockjaw is another triumph on the wonderful list; the lockjaw which but the other day was a decree of inexorable fate in every case. In America the cases ran into hundreds every year. "Now, such deaths are rare ly recorded." This successful war with disease is not confined to man. Forty years ago it was successfully practised in the epidemics of pleuropneumonia, which used to be so virulent in Australia. Inoculation was tried in the sixties in a crude form, simply by taking the virus from the diseased lung of a sick beast, mixing it with water, and passing the mixture into the tails of the sound members of the herd. The tails dropped off, but the beasts were immune from "pleuro." Now the thing is done with more care and certainty. At the same time, other diseases have been brought into

the scope of the treatment. Anthrax used to kill cattle to the extent of 5 per cent., and rouget destroyed 10 per cent, of sheep attacked. Pasteur operating on three million sheep and half a million cattle beasts in one year reduced the mortality respectively to 0.34 and 0.94. One might suppose that in view of these facts so progressive a country as the Dominion of New Zealand would have set up an up-to-date veterinary college. One would be wrong. Such are the results so far. They embrace but a few of the diseases to which the flesh of men and animals is heir. But science has made a beginning on the right track, and there is no reason to fear that in time the treatment will not be extended with success to every disease under the sun. The most interesting story in the whole collection deals with a disease well known in this country, the disease known as cretinism. The treatment is older than those to which reference has been made above, and is of a different character entirely. Whereas in those cases the principle is applied of like curing like, in this one the treatment consists in supplying a constituent of the human organism which though absolutely essential to the wellbeing of the system, is by some mischance absent in certain individuals. These pine away in a manner that for many centuries puzzled the medical men beyond the reach of conjecture. Such is a disease of women first described accurately by Sir William Gull, and known to the faculty as myxoedema. It is characterised by slowly advancing puffiness and pallor of the face, dryness of hair and falling out of the same, lassitude of mind and body growing to insanity and helplessness. The victims have to be cared for like children at home or sent to the mental hospitals.

The discovery of the cure was made by llorsley (Sir Victor) m a very strange, interesting and unexpected way. lie Avas engaged on a study of the glands of the neck and throat, the physiology of which was a sealed book to science at that time. llorsley proceeded by the method of depriving various animals of these glands and noting the effects. He began with the thyroid gland, and after failure in many animals he found results of a very decided character in monkeys. In them the removal of the thyroid gland produced the conditions described in women by Sir W. Gull, and known to the faculty as myxoedema. The next step was to try if the implanting in the human subject of the thyroid gland of some animal Avould effect a cure in cases of myxoedema. Horsley began by placing the thyroid of a sheep under the skins of patients suffering from the disease. He was delighted to find immediate benefit, but chagrined to discover in the course of time that the benefit depended on constant succession of the supply, a thing quite impossible, in the crude form adopted. He next tried injection of the juice of the thyroid, proceeded to administering an extract of the gland through the mouth, and at length established the settled practice of administering the dried extract of thyroid by tablets. Under this treatment there are no failures, all the victims recover; large numbers have been freed from the mental hospitals and returned to their friends perfectly restored in both mind and body. A kindred discovery followed naturally. The Swiss physicians called attention to the fact that the "cretinism" so prevalent in their country is really myxoedema m infants born without a thyroid gland. The same line of treatment was adopted, and cretinism is rapidly becoming extinct. Neither this affliction nor the myxoedema, which is due to the same or similar causes, being dreaded as they used to be. Now they are both regarded as curable, and they are regularly and infallibly cured. The subject of cretinism is of special interest in this part of the world as a remarkable cure was effected here in Wellington by Dr. Anson some fourteen years ago. The doctor had only just commenced practice in the house on Wellington Terrace previously occupied by Dr. Kemp. He was familiar with the new treatment, which was just coming into vogue in the days of his studentship. When, therefore, a case of cretinism was brought to him he had recourse to the thyroid gland of the sheep at once. As the preparations were not on the market at the time, the doctor had to get his material from the nearest butcher's and work it up. He effected a cure, and, as the Maoris say in the very opposite case of the man who kills the first of the enemy in battle, he "established his mana." The cure was very famous and very much discussed in the middle nineties, we remember. Now, of course, the treatment is perfectly well known and practised. Then, the doctor's patients regarded him as a magician, and when anybody looked doubtful, plunged into the true story of the helpless little imbecile who was turned into material for a healthy footballer in a brace of shakes. Where will these wonders end? We hope in a great cabinet in every house, labelled "Anti-toxin," with ranks on ranks of bottles bearing each the name of a common disease, each ready to send an expedition of well-bred microbes to exterminate disease germs that have got into the system. Why not? Invention is difficult, but practice is simple.