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"Favorite
Medicine"
Evidently Dr. W.D. Anderson has found that the drugs and procedures
taught during his college life are not altogether satisfactory. Like
many of us, he is being forced to rely more and more on observation,
hygienic directions, hope, and nature for the relief of many of his
patients suffering from the consequences of the presence of various
infecting organisms. His earnest request for information of "favorite
medicine" is the reason for this paper, in which a plan will
be laid before him that may be helpful.
Nature has earned the reputation of being the best of doctors, and since, by
far, the greater number of our maladies are the direct result of the presence
of germs or their sequelae, nature must have some simple and easily understood
method for their elimination; otherwise, the well-earned reputation as leading
in therapeutics could not have been maintained over so long a time.
With the recent collapse of the side-chain theory of Ehrlich, the very last
word in humoral immunity, the last vestige of faith in the "humors" as
protective of curative factors was removed. Without the Ehrlich theory, it
will be granted that we have no principle before us for the elimination of
germs, the repair of wounds, the demolition of pathological tissue. In view
of this dearth of therapeutic knowledge, I wish to discuss "the one constant
factor in resistance, whether innate or acquired – phagocytosis" [Metchnikoff].
Since the white blood cells have been used for a generation as indicators of
infection or the virulence of the organisms involved, it must be granted that
this mobile cellular system plays an important role in all infections. When
it is known that countless determinations during the past ten years have shown
that all the best used drugs and procedures in time past and time present have
a more or less potent influence in artificially stimulating this cellular force,
their consideration might be worthwhile.
Among the stimulants for the white cells, a beginning might be made with one
of the oldest, recorded remedial measures: cantharides ointment vigorously
applied in arthritis, as used in Greece early in the Christian era. With the
following erythema, the early classical observers might have seen marked changes
in the cellular picture had Van Leeuwenhock, the janitor in Delft, made his
discovery of the microscope a bit earlier – so with mustard plasters,
counter-irritants of all kinds, cupping, leeches, or bleeding of our medical
forbears, or queerly enough in the transfusions of blood of our time.
So, too, with drugs, mercury, whether by inunctions, the copious doses of calomel
of the past or the intramuscular or intravenous injections of the present,
counts before and after will show an immediate effect on the cellular system;
and with arsenic, bismuth, or serum injections; and also with the short wave
and the following induced fever or the therapeutic application of the X-ray
or the well-used diathermy of many of our colleagues. Counts before and at
hourly intervals after the use of any one of the foregoing drugs procedures
will demonstrate the effect of the procedure on the white cells.
Through this cellular system and its artificial stimulation by medical observers,
we have a straight line of therapeutic endeavor to connect us up with our Greek
colleagues before we became Christians.
Dr. John Edmonson, a local colleague, has suggested that this cellular army
of defense may be definitely likened to the defensive force of the nation.
In this national force, we have one army and one navy trained and equipped
to the resist inroads or enemies of whatever kind. We do not have a specific
army for each and every potential foe, but one centrally directed fighting
force as a nucleus to which we add millions of recruits by the draft when the
country is in danger. So in the ceaseless war with the enemies of mankind,
Dr. Edmonson thinks nature uses one defensive force, and only one.
Since the final proof of the truth of any theory of resistance and its control
is the effects to be observed on a sick man, means for the mobilization of
the cellular forces must at once be considered. Pretty well all drugs and combinations
of drugs have been tried and found wanting for one or many causes. In the consideration
of this plan for setting up more active resistance to the inroads of germs,
therefore, it might prove worthwhile to use a drug hitherto unused in the treatment
of infective diseases if we can be assured that no possible harm will result
and if there is any promise of the elimination of harmful micro-organisms.
The essential character of the white blood cells in resistance cannot be denied,
but these cells must have a proper field so that the best phagocytic work may
be done. Unfortunately, however, in cancer, diabetes, and many infections,
it has been recently shown by various laboratory observers that there is an
accompanying super-alkalinity of the blood. Now, this alkalinity must be the
direct result of the presence of germs to inhibit the aggressive activity of
the cellular, compared to the use of chlorine gas in the late disagreement
in France.
The white blood cells are acid in reaction, circulating in an alkaline medium.
Since hydrochloric acid is the only inorganic acid made by the body, it must
be the basic acid of the most delicate chemical balance of the blood. So if
there is a pathological variance of the normal balance of the blood, a logical
procedure would seem to indicate the injection of this essential acid. Now,
such an injection of this hydrochloric acid solution not only seems to have
a most beneficial effect on the blood reaction, but is also followed by an
increase in the numbers and activity of the white blood cells. The following
leukocytosis usually reaches its maximum four or five hours after the injection,
but there is left a well-induced phagocytic activity that is maintained 24
hours or longer.
Verification of the truth of this conclusion is furnished by the following
observations of good friends, who as yet are unable to draw conclusions from
these determinations. Three billion of the staphylococcus albus were injected
into a guinea pig. Examination of the cells after the injection of the organisms
showed that 23% of white cells had engulfed the cocci. We may conclude, therefore,
that this figure represents the natural phagocytic reaction to the injection
of the infecting organisms. Thereupon, the hydrochloric acid solution was injected.
Within two hours, 32% of the white cells were showing pronounced phagocytic
activity in engulfing the micro-organisms. The next determination, done 24
hours after the injection of the acid, showed phagocytic activity in 69% of
the white cells, an apparent improvement of over 200% on nature. Details of
these determinations follow (See Table 2, 73 KB .pdf).
The foregoing determinations give the writer a logical reason for the clinical
observations in the elimination of all germ varieties from infected individuals
and demonstrate beyond the value of the acid injections in augmenting the purely
natural phagocytic activity.
Besides the removal of germs, another daily problem of the surgeon and those
in general practice is the healing of wounds. Here, too, nature makes constant
use of the ubiquitous activities of the white blood cells as shown by Dr. Carrel
in 1922: "The existence of mechanisms causing leucocytes to invade tissue
in need of repair is certain. The initiation of healing seems to depend on
the coming of the leucocytes to the wounded tissue. The leukocytes have the
important function of promoting cell multiplication in the parts of the organisms
where they accumulate."
The truth of the observation of Dr. Carrel may be quickly demonstrated by an
artificial stimulation of the white cells by giving a few daily intravenous
injections of hydrochloric acid in preparation of patients for elective operations
or in the treatment of ulcers or infected or clean wounds. Surgeons will see
an astonishingly small number of infected sutures and a marked hastening of
the repair of the surgical wounds and shortening of the convalescence, particularly
if the injections of the acid be given every day or every other day after the
operation.
In recommending the hydrochloric acid injections for the stimulation of all
known and unknown forces of resistance in the treatment of infective diseases,
the writer does so with full confidence in the safety of the procedure and
the delightful freedom from the annoyances of the inflammatory reaction so
often seen after intravenous injections.
Readers of The Medical
World have only to recall the astonishing
results in the treatment of cancer and many infections reported by
Dr. Walter B. Guy, of St. Augustine, Florida, following the acid injections
with his own addition of various chlorides and potassium salts to know
that some powerful force is added to resistance. My good friend Dr.
Guy and I are not agreed as to the reasons for the results. He attributes
the undoubted clinical phenomena to the addition of the chlorides and
other chemical elements, while I persist in my conclusion that the
effects are due to the induced phagocytic activity and the modification
of the pathological alkalinity of the blood. However, we are in hearty
agreement on the good clinical effects of the acid injections.
Observations just published by Dr. Glover from the Public Health Service Institute
of Health, in which definite proof has been furnished of the infective origin
of malignant diseases, give a cogent reason for the good results reported by
Dr. Guy in the treatment of these hitherto hopeless maladies.
Our young colleague in Oklahoma may be disappointed in hearing of a "cure-all" in
answer to his request for papers on "favorite medicine." If this
impression is made, the writer can only reply that hydrochloric acid, in his
opinion, cures no ailment of any kind, but that its injection is followed by
a most marked stimulation of cellular and glandular activity not seen clinically
following any of the many other agents used for the stimulation of the white
cells. I contend that nature has a "cure-all" defensive system and
that it is to this force that we must attribute the unquestioned clinical results.
Such results only confirm the adage of the ages that nature is the best doctor.
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