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Emerson, in a study of the influence of carcinoma of the stomach on digestion, comes to the conclusion that in carcinomatous tissue there exist proteolytic ferments which carry the digestion beyond the albumose and peptone stages. Such ferments dissolved from the ulcerated surface of carcinoma of the stomach accelerate the action of pepsin, and their ultimate products, diamido bodies, et cetera, enter into loose combination with hydrochloric acid, thus accounting for the absence of free hydrochloric acid in such cases. This work, however, needs confirmation.

Buxton examined thirty tumors, obtained from various parts of the body, by chopping the tumor tissue to a fine pulp, adding enough of fifty per cent glycerin in water to bring it to the consistence of a soft paste, and sterilizing. Tests were then made for proteolytic ferments, amylase, lipase and oxidases. The experiments with proteolytic enzymes afforded uncertain results. As a rule the softer and more cellular tumors contained more than the denser varieties, but this was not always the case. It seems probable that the proteolytic enzyme of tumors is allied to erepsin. Amylase was found in every case, and it is significant to find it so constantly present in tumor tissue. The amount present did not seem to vary directly with the malignancy of the tumor. The very malignant tumors of the liver contained comparatively little. This again seems significant, since the adult liver contains glycogen, the embryonic liver none. In other tissues the reverse obtains except in muscles which do not enter into the question of malignant tumors. The tests for lipase gave results which if not indicative of the presence of true lipase show that there is something in the tumors which can rapidly convert butyrin into glycerin and butyric acid, and this power is destroyed on boiling. The experiments for oxidases led to no particular results, but as so little is known of these ferments and the necessary conditions for their action, this was to be expected. Since the idea of suboxidation as a cause of tumor formation seems to be gaining ground, it is necessary to furnish an experimental basis for the theory. An extended study of the oxidizing ferments found in tumors, and a comparison of them with those of normal tissues may help to confirm or to overthrow the hypothesis.

EDITORIAL COMMENT.

RABIES.

THE unusual prevalence of rabies in this section during the last few months has given this subject some prominence in the public mind. One practician of veterinary medicine has declared that more than fifty cases of this disease in dogs have lately come under his notice. A skeptic view as to its true hydrophobic character has been expressed, but the fact of two or three fatal cases recently observed in man has been sufficient to arouse considerable interest in the matter.

Notwithstanding the antiquity of hydrophobia its definite cause has not yet been ascertained. That it is essentially a disease of the nervous system has been demonstrated. The cause resides in the brain, spinal cord and nerves, not in the blood, liver, or spleen. It is also present in the saliva of the rabid animal and it is chiefly through this agency that it is spread.

The disease having been clinicly observed almost exclusively in man and the dog it is not so well known that other animals are also susceptible to it. Among these are the domestic cat, sheep, cattle, hogs and goat. Contrary to a general impression too the disease occurs in all seasons and in every section of the globe.

It is admitted that there is no cure for rabies. It is possible though to limit its spread. Rabid animals should be killed. Other animals. bitten by rabid animals should be confined and all dogs running at large should be muzzled for a period of three months. It has been found possible to safely disinfect a wound made by the bite of a rabid animal. in ninety per cent of the cases if done within the first twenty-four hours. In practice this precaution has been observed to be advisable even within seventy-two hours. For this purpose thorough saturation of the injured. tissues with fuming nitric acid is considered most efficient. Further than this vaccination of the infected person or animal after the manner of Pasteur is effective in preventing the disease.

In this connection it is of great interest to know that the Pasteur method of treatment for rabies can be obtained in this state. The Regents of the University have instituted a laboratory for this purpose in the Hygienic Laboratory, where residents of Michigan will be treated free of charge. The profession will gladly welcome this institution as through it they will feel more securely armed against this dread malady.

CONTEMPORARY.

IMMUNITY.

[BOSTON MEDICal and surgical journal.]

THERE is perhaps no question relating to medicine which has received so much attention from investigators during the past ten years, and which is so pregnant with possibilities for the future, as the subject of immunity. Its importance would seem to be sufficiently evident if the term were applied in its narrower sense, that is to say, in its relation to infectious diseases; but even a short excursion into the realm of recent literature shows that the term "immunity" as now used is a broad one, which cannot be circumscribed by considerations affecting bacteria and their products alone, but must be enlarged to include animal and vegetable cells of very varying character and origin. To the already well-known types of immunity seen after diphtheria, tetanus, typhoid and cholera, must now be added other varieties of immunity such as those produced by the action of red corpuscles, white

corpuscles, spermatozoa, et cetera; for all these cells bacterial or otherwise, when introduced in a proper manner into susceptible animals, produce tissue changes through which the animals acquire an increased resistance to those cells or their products, and it is the study of just these phenomena of increased resistance and its causes which offers such a bright outlook for progress in a number of directions, and especially in that of serumtherapy.

Although broad fundations for this study had been laid already by such men as Behring, Roux and Pfeiffer, at present the most important names associated with this question are those of Ehrlich in Germany and Bordet in France, and of these two, Ehrlich undoubtedly holds the higher place. It is to Ehrlich that we owe the now wellknown "side-chain" theory, which, though not perfect, furnishes the best working hypothesis yet discovered for the explanation of immunity, natural and acquired. According to this theory the process of intoxication such as is seen in diphtheria, for instance, is not in its essence pathologic, but is, in large degree, analogous to physiologic processes. as seen in the assimilation of food. That is to say, the diphtheria toxin is poisonous because there are certain body cells which take it up; which have certain "receptors" which attract and unite with the toxin just as the cell attracts and assimilates from the blood certain food molecules. On the other hand, if a certain animal is resistant to a certain toxin, it is because the cells of that animal possess no receptors capable of uniting with that toxin. When, however, the toxin becomes once anchored to the cell the analogy to physiologic processes, just mentioned, ceases, for in this instance, the toxic molecule causes an injury to the cell, that is, an intoxication. This injury the cell, if not too severely damaged, hastens to repair, but, according to the general law of repair, does not content itself with a simple restitutio ad integrum, but reproduces in excess that very portion of the cell which in the first instance united with the toxin. This excess is thrown off into the blood current, and there, by its continued affinity for the poison, acts as antitoxin. By the immunization of animals with gradually increasing amounts of toxin, we get finally the production of these cell receptors or antitoxin in great excess, and it is by these newly formed cell constituents, now free in the blood, that the toxin in diphtheria is neutralized and kept from its injurious action upon the body cells.

The probelm, as thus outlined, is the one seen in diphtheria and tetanus, and is comparatively simple. When we come to the consideration of typhoid and cholera, however. the question becomes much more involved. Pfeiffer in all his monumental work upon typhoid and cholera immunity could not produce a true antitoxin for these diseases. His sera were of the bacteriolytic variety, that is, they could dissolve, under proper conditions, the bacterial cell, but could not neutralize its toxic product.

It was at this point that the studies upon hemolysis and allied processes began, and as hemolysis and bacteriolysis follow practicly

the same laws, the two processes may be considered at the same time. In the first place we soon find that, in their relation to the "sidechain" theory, hemolysis and bacteriolysis are subject to conditions much more complicated than those seen in intoxications of diphtheria and tetanus. To be sure we have to do still with receptors and their indefinite multiplication as the result of inoculations with the especial variety of cell, but, whereas the receptor (or antitoxin) in diphtheria was of a simple variety known as a "uniceptor," with but a single bond of affinity, in bacteriolysis the specific body obtained as the result of immunization is an "amboceptor," with two bonds of affinity, one for the special cell and the other for a second substance, now spoken of for the first time, and known as the complement. This complement is a nonspecific body present in nearly all normal sera, and resembles in nature the ferments. It is very unstable, is destroyed at 58° centigrade, and disappears from a serum spontaneously with considerable rapidity. It thus differs markedly from the specific immune body or amboceptor, which is stable, resists heat (58° centigrade), and can be preserved unchanged for considerable lengths of time.

Now, for the destruction of the special cell, both the immune body (amboceptor) and complement are absolutely essential, the amboceptor acting as a connecting link, through which alone the complement can exercise its destructive power upon the cell. Neither substance can act in the absence of the other. That this is a fact of the utmost importance can be seen easily when we learn that, in the process of immunization (of a horse against typhoid for instance), it is the immune element alone which is increased to any extent. The amount of complement remains practicly unchanged. The probable cause for the failure of serumtherapy in this class of diseases is thus apparent. We have supplied the patient with the immune element probably in excess, but have achieved no convincing results because of lack of complement. The moral is obvious.

It seems, therefore, almost certain that in natural as well as acquired resistance to disease these complements, acting through natural or acquired amboceptors, are the defensive agents, and in support of this view may be mentioned the experiments of Longcope on terminal infections; Abbott, on the influence of alcoholic poisoning on susceptibility to infectious disease; and Moro, on the sera of breast-fed and bottle-fed infants. Terminal infections, alcoholic poisoning and bottle-feeding were all associated with marked decrease in the complements of the blood. These experiments suggest, immediately, of course, an explanation for the high mortality of alcoholics. in pneumonia, for instance, and that of artificially fed infants as compared with the breast-fed. The field for investigation in this line is really unlimited. For instance, why do certain families succumb to tuberculosis? Is there not a lack of complements? Are the complements increased by outdoor life? Was there not something good in that treatment of tuberculosis in which patients drank fresh blood at the slaughterhouses?

Another line of inquiry would have in view a serum antagonistic to cellular growths of malignant types,-cancer and sarcoma. Such sera have been produced by injecting animals with the proper cells, but the results of treatment are as yet discordant.

Finally, the far-reaching studies in hemolysis cannot but throw much light on the subject of the severe anemias, the causes of which have been up to the present far from established.

That the study of these subjects is most promising is shown furthermore by the large number of investigators engaged in it. All the world is represented in the work, and we may look with confidence to very important results in the near future.

MEDICAL NEWS.

THE PASSING OF A PIONEER PHYSICIAN.

EDWARD W. JENKS, of Detroit, a gynecologits of national repute, died last month while en route from Mexico, where he had been sojourning on account of ill health. The doctor was born in Victor, New York, and received his preparatory education at Ontario, Indiana, where his father founded a collegiate institution in 1843. Nine years. later he matriculated in the medical department of the University of New York, but failing health compelled him to discontinue study. Subsequently he became a student at the Castleton Medical College, where the degree of Doctor of Medicine was received by him in 1855. In 1864, after obtaining an aduendum degree from the Bellevue Hospital Medical College, he located in Detroit and soon became prominently identified with medical progress in this city. In 1868 he was instrumental in founding the Detroit Medical College, and was chosen president of the corporation and professor of obstetrics and diseases of women in the faculty. He also occupied a similar chair in the faculty of Bowdoin Medical College, beginning his lectures in the latter school at the close of the term in the former, but owing to the arduous labor involved he resigned the professorship in this school in 1875. For many years he was gynecologic surgeon to Saint Luke's and Saint Mary's Hospitals, consulting surgeon to the Women's Hospital, and physician to Harper Hospital from its establishment to 1872, when he resigned. He filled the position of chief surgeon to the Michigan Central Railroad Company for several years, and that of president of the Michigan State Medical Society (1873) and the Detroit Academy of Medicine. He was an honorary member of many American and foreign societies, and the author of numerous papers on medical topics, besides being associate editor of the Detroit Review of Medicine for four years and contributor to several medical works, notably Pepper's "System of Medicine." The degree of LL.D. was conferred upon him by Albion college in 1879, in which year he was also honored by election

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