UNFOUND CURES.

Taranaki Daily News, 27 November 1920, Page 11 (Supplement)

UNFOUND CURES.

WHERE MEDICAL ART PAILS. CONSUMPTION, PNEUMONIA, AND CANCER. NO SPECIFIC REMEDIES, Discussing Mr. Rockfeller's gift of 30,000,000 dollars for medical education and Research, Dr. William H. Porter, for nlany years professor in pathology and general medicine at the New York Post-Graduate Medical School and Hospital, remarked the other day that no specific medical cure for sonsumption, pneumonia, and cancer ever could be discovered. He said that the foremost men of medical science who had been delving for years to the roots of these blights 1 no longer looked for such a specific remedy in the realms of therapeutics and pharmacy (says a writer in the New York Times). Dr. Porter does not have the optimism of Dr. Mayo, who recently f«*erted that since the civil war fifteen years had been added to the average life of man by innovations in medical and surgical advance. He holds that the chief source of decreased mortality, or increased longevity, is due to the increased knowledge concerning the hygiene, and diet of infants. Reciting the progress that lias been made in rural and urban sanitary regulations, he says "our sources of milk supply have been clearly scrutinised, until now enteric disorders in epidemic form are almost unknown," and this lie thinks, is one of the most important of all reasons for. lofiger life to-day. Dr. Porter admits the failure of his profession to triumph over the more destructive diseases. lij response to a query about his view of the Rockfeller gift, Dr. Porter said: ''Much good has already resulted from the funds established by Mr. Cam. ; egie in his lifetime, and by Mr. Rock-' feller, for the advancement of medical! science, and I am sure that these later donations on the part of Mr. Roekjeller of 20,000,000 dollars to the General Education Board, created by him, to be expended for medical education and research, and of 10,000,000 dollars to the Rockfeller Institute for Medical Research, will go a long way toward enabling the American school of medicine to take its rightful place among the enlightened nations of the world. "I am of opinion, however, that the chief benefits which have arisen from these endowments thus far consist in the improvement of our laws requiring bet' ter qualifications on the part of applicants for a license to practice medicine, We still need more legislative safeguards, and there is room for reform in the matter of adjusting tlie curriculum and improving the clinical facilities of the average medical college.

COMMON SENSE IN RESEARCH ''ln the matter of research theri. is greater need to-day than ever for ample funds to extend the great work of experiment and investigation. But I bjlieve it should bo acknowledged at th» outset that no research can ever possibly discover a specific remedy which will cure such diseases as tuberculosis, pneumonia, and cancer. I don't believe that the experts Mr. Rockfeller has commendably brought together on his stage of medical investigators will wa3te much of their time, or much of his money, trying to find a cure for tuberculosis and pneumonia, for the reason that it is now a known fact that anything powerful enough to kill the germ may be equally destructive to the patient. "With diseases which' we call 'selflimited' it is now accepted as true that we can shorten their duration and decrease their intensity.' I assume, therefore, that Mr. Rockfeller's scientists will direct their research in this direction. "This is not pessimism. It ; s common sense. We all remember what a thrill of elation took held of the medical profession, and what a feiling of satisfaction seized the civilised world, when Dr. Koch, famed for his mastery of bacteriology, announced that he had discovered a curie for consumption. Many doctors and scientists took him at his word. His brilliant schievements in the past made it imperative that he should be taken seriously. In my practice and my work at the Postgraduate Medical School I made it clear then that we were not justified in believing that any specific 'cure' could be elaborated for any pathological condition, although nature does not develop anti-bodies and defensive proteins, as well as encysting processes and other means of self-limiting certain conditions which remove or overcome toxins, and, in this way, facilitate a restoration to normal conditions. "In connection with my work at the Post-Graduate Medical School and Hospital I insisted that I did not approve of any experiments involving human life with Dr. Koch's so-called cure. Years have passed, and the Koch' 'remedy' has passed with the years, and so have all the 'remedies' offered by lesser lights."

DOUBTFUL PROSPECTS. "But why despair?" the interviewer added. "Isn't there a remote possibility that some day a germ culture may be found which will spare the life of the patient? Had not the medical profession given up all hope in the case of diphtheria and in the case of tetanus, and did not research bring at last the; antitoxin which effects a profound amelioration of these diseases?" "It required long years of medical research to find the germ of consumption, and longer to discover the germ of pneumonia," Dr. 'Porter replied, "and many long years have been spent in the arduous search for some specific for these germs. In the ease of diphtheria, antitoxin mitigjate the severity of the disease. But even here, the patient must undergo the strain of a wellnigh lethal dose. It is well to add in this connection that anti-toxin is chiefly oflective in the prevention and removal of the membranous exudation, which is tie principal cause of death from uncomplicated diphtheria. "It is just tho opposite in the case of a new serum now used against the typhoid germ. After a patient has become infected with the typhoid germ it is of little avail to inoculate .that patient with the anti-typhoid serum. It acts well, however, as a vaccine, and produces immunity from the disease quite effectively as the smallpox virus. "The pneumococcus, or germ of pneumonia, was discovered by Dr. Friedlander in 1883. Since that time countless experiments have been made in the hope of finding a specific cure. Dr.

Sternberger, our noted army surgeon, has played a conspicuous part in this research work for a pneumonia cure. Wo have all heard the claims of enthusiasts to the effect that they can cure pneumonia by abortive means—by eliminating the disease through the liver and so forth. This claim is confused either with preventing or with decreasing the intensity and shortening the duration of the disease, for we I do not have an actual pneumonia until the air sacs are filled with an inflammatory exudation, and the only way to remove this is by nature's process of fatty degeneration and liquefaction, the liquid product being removed from the lung only by being coughed up, or by being absorbed through the lymphatic channels. ori(\e obsorbed into the lymphatic -channels these products are eliminated through the liver and kidneys.

STIMULUS TO EDUCATION, '"Where Mr. Rockfeller's donation will work its greatest good will be in medical educational lines, as well as along the lines of research. The medi--1 cal profession in America must be made to study general medicine more. Specialism must be earned, not adopted. The specialist of the past studied general medicine, and was graduated as a general practitioner. In time he found his talent, his skill, and his propensity of inclinations all led him into one particular branch, not by premeditated selection, but by natural bent. It doesn't matter what a young doctor wants to be. If he is ever to be successful in any branch of the profession of medicine he must follow the trail of his talents, and no matter what he undertakes, he will never be a successiul doctor until he has laid the foundation by mastering chemistry, physics, and biology. "Our medical colleges are not teaching enough chemistry and physiology. In this respect they are falling behind the older institutions of medical training. 'When I went to a medical college some forty-five years ago, we had four or five lectures a week on physiology, ■ so that in five months we had as many • lectures on this very important branch •of the science as they give nowadays in two years. We were compelled to continue to study physiology and chemistry long after we had taken the regular course, sometimes going over a textbook two and three times. Life, from start to finish, from maturity to decay, is one long chain of chemical processes, and our research work must be speeded up until we get our American schools of medicine up to the very highest possible standards of efficiency. ''l note that Mr. Rockfeller's donation will be expended directly for education and research work, and not for propaganda. I don't know whether hj« classes as propaganda such Vork as eradieting hookworm, putting down pellagra, and so forth, which lie has been accomplishing to such great benefit for the South, and to audi great advantage to the medical profession everywhere, but I don't know whether he intends to cease his endeavours before Legislatures to bring about higher standards of proficiency in our medical schools, but I do know that this work ought to be stopped until all institutions have a uniform standard of excellence, "Indeed, I am of the opinion that our profession of medicine would gain more just at this time in Lhe way of uplife by having Mr. Rockfeller's fund directed toward education and laws requiring education as well as by spending it for practical research. We need more groundwork. Let us get hack to teaching chemistry, and keep on teaching . chemistry with physiology, and th»n teach chemistry with pathology, aiui! keep on teaching chemistry to the last lesson in therapeutics, and we may hope to put oitr medical college on the proper basis and hold it up to its essential standards. THE BLIND ALLEY OF CANCER. "Much research has been expended by these endowed institutions in seeking a cause for cancer as well as a remedy for this condition. Only within the last few yeara a woman of Boston left at her death nearly half a million dollars for a commission of American, British, and French doctors to spend trying to find the origin of cancer and its cure. Those doctors studied cancer in every land and every clime, and the upshot of it all was that we stand to-day about whye, we have always stood—no positive -nodical or surgical remedy has been found, "There is no cure for cancer in the realms of our present knowledge of medicine, because cancer, so far as we know, docs not originate in a microorganism. Cancer is not one of the self-limited diseases, because it has its origin in an embryonic cell, or in a group of embryonic cells, caught in some tissue which, subsequently, because of irritation, or through some twist or defect in the nutrition of the area, becomes a fertile soil for the development of the growth of the cancer cell. Hence, we can see that research work in the* 'investigation of canoer ought to be confined to those chemical processes involved in defective metabolism, and in the development of a nutritive pabulum which tends to exeite super-activity in these embryonic cells. If research work could develop some method by whcli these embryonic cells could be discovered, and if a safe way could be devised for their complete removal, then the cure for cancer might be established, assuming that this is the true cause and method of development of the cancerous process."