AUTO-INFECTION IN ABDOMINAL DISORDERS.
In view of the complications arising in the course of abdominal diseases from auto-infection, and with our recent knowledge in regard to this important but insidious factor, it behooves the physician to be on the look-out for such manifestations. Toxic anemia, as portrayed by Dr. John E. Bacon, in our last number, brings to light some valuable truths which should ever be uppermost in the minds of those having to deal with occult affections.
Considering that we now have ample evidence that a sick person may be his own worst enemy, by reason of an unhealthy condition of the alimentary canal, it is not too much to assume that in many cases of prolonged illness, the complications arising may frequently be due to auto-infection, and thus, in addition to the disease which is seen, there is another disease engrafted upon the first which is insidious but persistent. The plan of using purgatives to unload the intestinal tract and relieve the portal circulation has its value, but the habit, once established, cannot be relieved permanently by this method. The addition of antiseptics is likewise a valuable feature in the treatment of this class of cases, and the two combined will often serve a useful purpose; but cases occur in which either method alone, or both combined fail, and it is then that we are compelled to study the philosophy of cell-function.
In this connection, the studies of Pohl, as elaborated by Chittenden, promise to shed a flood of light upon the vexed and complicated problem which involves the theory of nutrition. If digestive leucocytosis, as delineated by these authors, be true, and we have no reason to doubt their conclusions, then we have a satisfactory explanation of the value of proper food for the sick, to say nothing of the nutrition of those who ordinarily enjoy good health. The fact being admitted that white blood-corpuscles or leucocytes are more rapidly developed after the ingestion of food, it follows that this cellular activity was intended to accomplish or aid in accomplishing certain metabolic changes. And when to this fact we add the knowledge advanced by Metschnikoff concerning the function of phagocytes, which are said to be modified white blood-corpuscles, together with the scientific demonstrations of Vaughan, that these cells produce through the activity of their nucleus an antiseptic substance, we have a complete scientific explanation of the need for suitable food stuffs, not only in illness of every description, but also as a precautionary measure against disease.
It is time that the study of the class of cases under consideration should be placed on a scientific basis, in order that we may have some definite idea of the objects to be attained—and the method of attaining them—expressed in terms which may be comprehended by the merest tyro in therapeutics, and to this end the contributions of Metschnikoff, Pohl, Chittenden and Vaughan must be accepted as valuable preliminary data. The next thing in order will be to make these scientific facts clinical facts by making them practical, and it is therefore necessary that others should take up the task in order that the work may be carried to a successful termination.
THE PRINCIPLE INVOLVED IN THE SUBCUTANEOUS USE OF BLOOD-SERUM.
An important revelation has been made to the medical profession in the form of a communication to the Medical News (Jan. 13, 1894), by Dr. C. F. Darnall, of Llano, Texas. According to the report, twins suffered from ptomain-poisoning, and one of them died. The surviving child was treated by the subcutaneous employment of a normal salt solution, but without apparent benefit. Later, this was followed by the use of two ounces of blood-serum drawn from the arm of the father, a healthy young man. To quote the words of the author, “The child was carefully watched, and reaction occurred in about six hours. Improvement gradually took place, and in six days, upon a diet of thin corn-meal gruel at first, later by fresh milk prepared, the child was well. It was placed at the mother’s breast at regular intervals, and at the time of writing, nearly nine weeks after the onset of the illness of the children, the lacteal secretion is fully established.”
Now, this is evidently a very interesting case, and all physicians who wish to understand the “whys” and “wherefores” would like to have some additional light thrown upon this occult subject. In this instance, there is no intimation that the father had been previously rendered “immune” to the peculiar ptomain which, in this case, is supposed to have been derived from a can of condensed milk. How, then, could this blood-serum have exerted a favorable change in the metabolism of the infant which was but ten weeks old? Our bacteriological friends will tell us that the benefits were due to the “natural antiseptic properties” of normal blood-serum; but the clinician and intelligent and conscientious physician will want to know from whence this peculiar property is derived. The blood is an alkaline fluid, and we are taught that antiseptic solutions, to be effective, must be acid. How does it happen, therefore, that blood-serum obtained from normal blood, which is alkaline, possesses antiseptic properties?
This question has already taken up so much space in the journal that, aside from our prospective subscribers, it would not be advisable to take further time for its elucidation. It will be sufficient, however, to say that it involves a principle first developed from a scientific standpoint by Professor Vaughan, who has shown conclusively that the antiseptic property of blood-serum is due to the fact that the nucleus of the white corpuscles secretes an actively antiseptic substance, a substance having all the characteristic of a proteid, which he has denominated “nuclein.” At the risk of becoming monotonous in furthering this measure, we repeat that nuclein solutions may be obtained from yeast-cells, from the yelk of the egg, from the thyroid gland, from the spleen and from other organs of the body, and when properly prepared, they are as powerful in modifying the multiplication of microorganisms as is corrosive sublimate or any other recognized bactericide. The principle underlying the subcutaneous use of blood-serum is, therefore, demonstrable, and is strictly within the confines of scientific medicine. How long it will require to educate the medical profession in this knowledge remains to be seen; but if it was merely an empirical claim or chimerical fancy, and backed by sufficient capital or government patronage, the period would be short indeed.