Billeder på siden
PDF
ePub

Undoubtedly the best experimental work abroad has been done by Jensen, whose inoculation of mice and rats by tumor tissue from a case of cancer in a mouse, has shown the growth can be continued, by inoculation, through nineteen generations of mice. He shows that there is a proliferation of the transplanted cells and not of the fixed cells of the animal, and that he could cultivate no parasite from them. Most important of all, however, is the fact that he has been able to inoculate abbits and rats, and from those in which the tumors spontaneusly disappeared, obtained serum which, when injected into already infected animals, caused shrinkage and sometimes disappearance of the tumors, and in others gave immunity against infection. This is the problem to which most serious thought is directed.

The question at once comes up, has any anti-cancer serum yet been found for man, or may we expect it?

By analogy we must wait until animals can be inoculated by cancer from man, and then take their serum. No successl inoculation has yet been-made. Animals will occasionally generate small nodules of growth, from irritation about an nfarction of infected cancer cells, but never a cancer. The dog's peritoneum will digest large pieces of fresh cancer.

Perhaps some human serum from a case of spontaneously cured cancer may serve. These cases are rare, but do show the possibility of human immunity.

Assuming that cancer is of parasitic origin, we may yet hope that its advocates may produce a serum. Doyen has lately claimed his micrococcus neoformans as the specific microbe, and is the latest advocate of an anti-cancer serum.

This bacterium has been shown by Calmette to belong to the staphylococcus family.

After a recent exposure by lawsuit, Doyen was obligated to reveal his secret serum. A commission of eminent surgeons will report on his claims in the near future. I have it from the best authority that his claims are entirely unfounded.

Metchnikoff, of the Pasteur Institute, after full investigation, states explicitly that the specificity of the micrococcus neoformans is by no means established.

Many other anticancer sera have been advocated, but not one has stood the test of experience.

After the legtimate use of the knife, therefore, the surgeon has today no legitimate resource with which to fight cancer, unless it be the Roentgen ray or radium.

It remains then to speak finally of this new problem of radiant energy. My reliance on X-ray therapy in all superficial epithelial cancers is considerable. In recurrent cancers of the breast also it has lifted the gloom of former years, and added months and years of hope and comfort to every patient's life. But that chapter has been often written.

Of the use of radium, I can speak from two years' use of the strongest radium, which I was fortunate enough to obtain early, and from watching foreign reports.

It may be said in summing up that it cures, with a fair degree of precision, lupus and superficial epitheliomas, and has caused retrograde change, and disappearance of malignant growth of sarcoma, both giant cell and alveolar, which X-ray would not touch.

Its arrest of the growth of seeds, which will not grow after a few hours of exposure to the rays of radium, which is hermetically sealed in a glass tube, tells the story of its similar action on nests of malignant cells.

The intense penetrating energy of radium rays is shown by an accurate picture of a metal object, like a key, laid on a photo plate in its plate holder beneath a piece of whetstone an inch thick, with a grain or two of radium held a foot away.

These rays travel at almost the velocity of light, but are not deviated as the latter by prisms, or interposed substances. They are electric particles, charge negatively, and energize living cells. The theory of its action is not settled, but microscopically nests of cells are seen, under its influence, to retrograde and dissolve, leaving only fibrous elements of repair.

Thus we may hope to have found one more potent agent with which to combat some phases of this dread disease. The problem now is to get enough radium to satisfy the demand.

In conclusion, gentlemen, may I say that the task remains for you and me to help clear up the unfinished problems. The honor will surely come to some one, and why should not you or I be the one "to grasp the apparently incomprehensible idea and put it in comprehensible language?"

12

MONITOR'S ADDRESS.

BY WILLIAM GLASSELL SOMERVILLE, M. D., OF TUSCALOOSA, Junior Counsellor of The Medical Association of the State of Alabama.

Mr. President, Ladies and Gentlemen:

To the physician beginning the practice of his profession, as well as to those who have been in the practice for years, many questions arise as to what their conduct should be in certain contingencies. If everyone were good, if everyone were noble, if everyone were generous, if everyone were kind, laws to govern us would be unnecessary; but we are human, we are ignorant, and we need rules of conduct to direct us. As a suggestion and partial guide, the "Principles of Medical Ethics" has been promulgated by the American Medical Association, and is a revision of the old "Code of Medical Ethics." If we go back more than two thousand years, to the time of Hippocrates, we find the same sentiment expressed in the physician's oath, which to this day bears his name, and which it is even now the custom in some colleges to administer to their graduates. This is in part the Hippocratic oath :-"I swear by Apollo, the physician, and Aesculapius, that I will reckon him who taught me this art equally dear to me as my parents, to share my substance with him, and relieve his necessities if required, to look on his offspring in the same footing as my brothers, and to teach them this art if they should wish to learn it. I will follow the system of regimen which, according to my judgment, I consider for the benefit of my patients, and abstain from whatever is deleterious. will give no deadly medicine to any one if asked, nor give any such counsel. With purity and with holiness, I will pass my life and practice my art. Into whatever houses I enter, I will go into them for the benefit of the sick, and will abstain from every voluntary act of mischief and corruption. Whatever in connection with my professional practice, or not in connection with it, I hear or see in the life of men, which ought not to be spoken of abroad, I will not divulge, as reckoning that all such should be kept secret." What could be more beautiful than the moral sentiment contained in this

I

oath, which applies to-day as well as it did two thousand years ago? Everything we find in medical ethics is altruistic; but is it not understood by the laity, who consider medical ethics. the ways and means physicians have of avoiding something they do not wish to do, or a combine to make money, or something, they don't know what. In fact their ideas are rather confused as to what it is. Ethics in general, or rather moral science, may be defined as the science which decides for us what conduct is right. Moral Philosophy teaches us why it is right, and is a justification of the principals implied in moral science. Ethics, however, must be considered both as a scientific and as a philosophic study. "As a science, it aims to discriminate between, and to classify acts as right or wrong; as a philosophy, it aims to furnish and to justify the principles, according to which the discrimination and classification may be made." The laws of right are immutable; as such they have always existed, and will forever exist. With some of these laws, we are familiar, and concerning which we have no doubts. "But as to many things we may not know clearly the right and the wrong, there may be various and contradictory opinions about them; and yet we may feel that there is a right and a wrong, and that it is for us to find them out in each particular case. No more than the facts of nature are the ideals of morality dependent on our opinion of them;there is a true, a best, a wholly right way of doing everything. It is not for us to make this, to try to create it; we cannot, indeed, make it or create it any more than we can the sun in the heavens:-we have simply to discover it." Nevertheless, it exists as surely as the law of gravitation existed before Newton discovered it.

In our daily lives as men, as women, and as physicians, we are confronted by the questions,-what is right? What ought I to do under certain circumstances? If we would always remember and follow the Golden Rule, as given us by Christ,―"Whatsoever ye would that men should do to you, do ye even so to them," there would be few discords, less misunderstandings,-life would be more beautiful, more sublime; for whatever is good for us, whatever is dear to us, is likely to be good for others.

It is not for me to decide which of the various theories of right and wrong is correct,-the intuitive, which relies exclusively on intuitive perceptions as furnishing an ultimate ground of right-the utilitarian, which makes doing right a mere

means to an end, and makes the end to be one's own present or future happiness, egoism; or one's own happiness with due regard for the happiness of others, egoism and altruism, "the greatest good of the greatest numbers;" or happiness and pleasure entirely for others, without regard for self, pure altruism. We should not "live for self" alone, nor should we "live for others" solely. There should be a reconciliation,-an harmonious blending of the two, egoism and altruism.

A moral act should be our own free act, not one merely in accordance with custom,-it must be one not only followed by good results, but one in which good results are intended. Neither should hope of reward, nor of happiness, be an incentive for doing right, nor should fear of punishment be that which should deter us from doing wrong, or being unjust to others. We should do right because it is right and just; and if happiness and reward come as results, let them come "unsought and unbought.”

"What means have we of knowing what given act is right or wrong? There is but one way, and that is by Conscience, which is inborn, evolved by hereditary transmissions, and perfected by training and experience:-by Conscience, which is "the mind's power to judge its own acts and itself as the doer of them:"-Conscience, "the moral judiciary of the inner self, the judge and the arrigned being one and the same person."

The "Principles of Medical Ethics," as adopted by the American Medical Association, is founded on the highest moral principles, and is divided into three main divisions:

(1) The duties of physicians to their patients,

(2) The duties of physicians to each other and to the profession at large,

(3) The duties of the profession to the public.

Time will not permit me to quote to you every sub-division. The beauty, the simplicity, the grandeur of these principles are supreme. Section one states,-"Physicians should not only be ever ready to obey the calls of the sick and the injured, but should be mindful of the high character of their mission and of the responsibilities they must incur in the discharge of momentous duties. In their ministrations, they should never forget that the comfort, the health, and the lives of those entrusted to their care depend on skill, attention and fidelity. In deportment, they should unite tenderness, cheerfulness, and firmness, and thus inspire all sufferers with gratitude, respect

« ForrigeFortsæt »