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treated with the blood or the organs of other species of animals. For instance, the blood serum of a sheep which has been treated with the blood of a rabbit becomes poisonous because it has acquired the power of dissolving the red blood corpuscles of the rabbit. It is a poison in the case of the rabbit, but is harmless to most other animals. The injection of the rabbit's blood into the sheep has conferred on the sheep a new property which comes into operation only with regard to the red blood corpuscles of the rabbit. We have here to do with something analogous to what has been observed in the cases of serums used to arrest infectious disease. When the bacilli of diphtheria, or their products, have been injected into horses, there is produced an anti-diphtheric serum, capable of curing diphtheria, but powerless against tetanus or plague. After M. J. M. Bordet of the Pasteur Institute had made his discovery of serums that had acquired the power of dissolving the red blood corpuscles of other animals, the attempt was made to prepare similar serums directed against all the other elements of the body, such as white blood corpuscles, renal and nervous cells. In the course of these investigations it was proved to be necessary to employ a certain dose of the serum in order to obtain the poisonous result. If smaller quantities of the poisonous dose were used, the reverse effect was produced. Thus a serum, strong doses of which dissolved the red blood corpuscles and so made them less numerous in the blood, increased the number of these when given in very small doses.

M. Cantacuzène was the first to establish this fact in the case of the rabbit, whilst M. Besredka and I myself did it in the case of man. Since then M. B'élonovsky of 1 Annales de l'Institut Pasteur, 1900, pp. 369-413.

Cronstadt has confirmed the result on anæmic patients, treating them with small quantities of serum. He has been able to produce in them an increase in the number of the red blood corpuscles, and in the quantity of the red colouring matter (hæmoglobin) in the blood. Later on M. André1 devoted much attention to this matter at Lyons. He prepared a serum by injecting human blood into animals and made use of it in the case of several persons who suffered from anæmia from different causes. In the case of patients, the anæmic condition of which had hitherto remained stationary, Dr. André found a sudden increase in the number of red corpuscles after injecting small doses of the serum. M. Besredka, in the case of laboratory animals, increased the number of white corpuscles by injecting them with a small quantity of a serum, strong doses of which destroyed these cells.

These facts are only a special case of the general rule that small doses of poisons increase the activity of the elements that are killed by large doses. In order to increase the activity of the heart, medical men give successfully small doses of cardiac poisons such as digitalis. As a commercial process, the activity of yeasts is increased' by submitting them to weak doses of substances (fluoride of sodium) which, given in larger quantities, would kill them.

My general conclusion from these facts is that it is logical to lay down the principle that the higher elements of our body could be strengthened by subjecting them to the action of small doses of the appropriate cytotoxic serums. There is, however, much difficulty in putting this into practice. It is quite easy to obtain human blood to inject into animals with the object of preparing a serum 1 Les sérums hemolytiques, Lyon, 1903.

which can increase the number of red corpuscles. On the other hand, it is extremely difficult to get human bodies sufficiently fresh to use them for a practical purpose. According to law, post mortem examinations can be made only after an interval of time in course of which the tissues have changed; besides, the organs obtained in this way are frequently affected by injuries or diseases militating against their use. Even in Paris, with its three million. inhabitants, it is extremely rare that there is a good opportunity for the preparation of human cytotoxic serums. In two or three years, during which Dr. Weinberg has collected the organs from human bodies fairly fresh, he has been unable to obtain sufficiently active serums.

The best results have been obtained from new-born infants which have been killed by some accident in the process of child-birth, as in them the organs are in a normal state. However, owing to the advance in the practice of obstetrics, such accidents, already infrequent, are becoming extremely rare. In such conditions we may have to wait long before getting a positive result, unless the future will find some method of obtaining the necessary materials for this difficult and interesting purpose.

As it is so difficult to prepare a remedy which can strengthen the weakened higher elements of the body, it may be easier to find a means of preventing the weakening which interferes so much with our desire to live long. As the products of microbes are the most active agents in deteriorating our tissues, we must look towards them for the solution of the problem.

IV

INTESTINAL PUTREFACTION SHORTENS LIFE

Uselessness of the large intestine in man-Case of a woman
whose large intestine was inactive for six months-Another
case where the greater part of the large intestine was com-
pletely shut off-Attempts to disinfect the contents of the
large intestine-Prolonged mastication as a means of
preventing intestinal putrefaction

THE general measures of hygiene directed against infectious diseases play a part in prolonging the lives of old people, but, in addition to the microbes which invade the body from outside, there is a rich source of harm in the microbes which inhabit the body. The most important of these belong to the intestinal flora, which is abundant and varied.

The intestinal microbes are most numerous in the large intestine. This organ, which is useful to mammals the food of which consists of rough bulky vegetable matter, and which require a large reservoir for the waste of the process of digestion, is certainly useless in the case of man. In the "Nature of Man" I have dealt with this

1 According to a recent publication of M. Ellenberger (Archiv. f. Anatomie u. Physiologie, Physiologische Abtheilung, 1906, p. 139), the cæca of the horse, pig and rabbit, play an active part in the digestion of vegetable matter, which is rich in cellulose. At the end of his treatise, Ellenberger insist that the vermiform appendix of the cæcum is not a rudimentary organ. The reason why the appendix can be

question at length, as it was an important example of what I regard as the disharmonies of the human constitution. A case upon which I have always laid great stress is that of a woman who lived for thirty-seven years, although her large intestine was atrophied and inactive, as this seems to be a remarkable proof of the uselessness of the organ in the human body. The small size or complete absence of the large intestine in many vertebrates confirms my conclusion. None the less, some of my critics think that my argument is incomplete. To strengthen it, I may call their attention to a medical observation which is as valuable as if it had been an experiment. It relates to a woman, sixty-two years old, a patient of Prof. Kocher at Berne. She had been suffering from a strangulated hernia associated with gangrene of part of the intestine, and had to be operated upon suddenly.

The gangrenous portion of the ileum having been removed, the healthy part was implanted in the skin so as to form an artificial aperture through which waste matter from the food passed to the exterior without traversing the large intestine. Although the patient was old and seriously ill, the operation, performed by M. Tavel, was quite successful. Six months later, in a new operation, the small intestine was rejoined to the large intestine so that the fæces were again able to pass to the exterior by the natural channel. In this case, then, the large intestine was thrown out of use for half a year, not only without injury to the general health, but with the result that the patient was comremoved in the case of man without disturbance to the functions of the body, is that this work can be performed by the Peyer's patches of the intestine. The existence of the appendix is not necessary to the normal processes of the body, and is a real danger to health and sometimes to life. Comparative study of the cæca in birds shows that these organs are in process of degeneration.

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