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ization. Personally I have frequently been im- tion. Many factors involved in its causation pressed by cases of appendicitis occurring after main still undeniably obscure, but out of the patient was markedly fatigued. Here a pos- obscurity many flashes of light are coming sible analogy is suggested to the experiments of The role played by lead in the production Charrin and Roger who found that the suscepti- chronic nephritis in painters, has been recogniz bility of rats to anthrax infection was markedly by physicians for nearly a century. Since, hol raised after the animal is fatigued by running in ever, painters do not have a monopoly of chrop a treadmill.
nephritis other causes must be at work. In In diseases of the liver apart from definite search for other cases laboratory workers pyogenic processes, evidence is constantly ac- this and other countries have made contributio cumulating to prove the role played by bacteria. of lasting interest and worth. Nicholls and Ford, as previously mentioned, have
The workers in this field began first to shown that livers in health contain bacteria and
periment with chemical poisons, and we kno it seems reasonable to assume that in patients
from the brilliant investigations of Dickson with foci of infections the bacterial content would
Christian, Brown, Baehr and Ophüls that be increased. This idea, too, has been seized
quisite pictures of both acute and chronic upon by enterprising journalists who have told
phritis can be produced by injecting into anima the lay press that the liver is nothing more nor
repeated doses of such substances as uran less than a big bacterial filter for the human
nitrate, potassium bichromate and iodine. T body. This statement with limitations may be
work has been especially valuable in show accepted as approximately correct, but what in
that chemical substances which damage the k terests medical men most is why this big bac
neys and produce acute nephritis after a sing teriological filter gets clogged up.
injection will, if repeatedly injected, indu Hektoen, Weaver, Abbott and others have de- chronic nephritis. scribed liver lesions often simulating closely a Further laboratory work done along simu hepatic cirrhosis, following the injection of bac- lines, using bacteria or their products instead teria. The production of cirrhosis in their ex- chemical poisons, has also added to our kno periments were, however, on the whole, rather edge of the etiology of chronic nephritis. T inconstant, and the lesions most frequently pro- relationship between infectious diseases and act duced were simple areas of necrosis. Opies nephritis was appreciated by the earliest wor classes well known experimental production of ers in bacteriology. Thus we find Kannenber liver cirrhosis with chloroform and colon bacilli as far back as 1880 emphasizing the relatiouse has advanced our conception of this process. between acute nephritis and tonsilitis and Also it has emphasized again the important cor- 1884 we have a dissertation by Ernst describi relation between bacteria and trauma — the two cases of acute nephritis associated with pre trauma here being chemical and consisting of a monia in which he demonstrated bacteria chloroform necrosis of the liver. In our labora- microscopic sections of the kidneys. In tory it might be mentioned that large pyogenic Mannaberg produced acute nephritis in rabos abscesses of the liver were produced by first and dogs by the intravenous injections of strepi damaging the liver tissue through subcutaneous cocci which he obtained from the urine of administration of phosphorus and then injecting tients with acute nephritis. Mannaberg believe staphylococci intravenously.
that these streptococci were specific organism Opies' work, of course, opened up a fresh and affected the kidneys electively, and in discussion as to the role of alcohol in the pro- work we see the idea of the selective affinity duction of hepatic cirrhosis. Many pathologists Streptococci which has had such an influence have expressed the view that in cirrhosis the upon our ideas of infection. alcohol acted only as a chemical trauma, while
ted only as a chemical trauma, while Studies, however, showing a relationship be certain clinicians, skeptical and wisely so, per- tween bacteria and chronic nephritis are of mo haps, have still clung tenaciously to the alcohol recent origin. A number of papers have a per se theory. Perhaps it would be well to peared recently in which the typical lesions declare a truce just now between pathologists chronic nephritis were produced by the expert and clinicians and leave the question to be set- mental injection of micro-organisms. Bailey, tled by the next generation living under univer- reported chronic nephritis following repeated sal bone-dry laws.
jections of colon bacilli, Klotz has describes Investigations into the causation of diseases similar results after injections of streptococci a of the kidney, especially chronic nephritis, have Winternitz and Quinby have produced chrom in the last few years received much stimulus kidney lesions following the injection of cultur from bacteriological investigations. Chronic ne- of B. bronchosepticus directly into the reh phritis, a disease which annually exacts death arteries of dogs. Our own work has shown tha toll of over 60,000 in this country, has long been cultures of B. mucosus capsulatus induce regarded as one of the diseases of obscure causa- changes in the kidneys of animals. We have
present a culture of the B. mucosus capsulatus a ation is inhibited by a diet of carrots. It is also single intravenous injection of which produces possible that cresol and phenol formation is likean intense acute nephritis, while repeated injec- wise inhibited and these two substances as is well tions give rise to a chronic nephritis, with al- known are severe renal irritants. bumen and casts in the urine. An interesting In summarizing these observations up on sevmicroscopic finding in our experiments is the eral disease conditions having a close relationmarked damage to the glomerular apparatus ship to foci of infection, it might be remarked which is in harmony with the pathological find that in our vigorous pursuit of offending microings in cases of human chronic nephritis. organisms important as it is, we should not neg
The interesting question also as to whether lect the factor of trauma-as aiding these orthe toxins of bacteria are of themselves able to ganisms in firmly intrenching themselves. produce chronic kidney lesions, was studied in Studies along these lines are urgently needed another series of experiments. And here we and will unquestionably shed much light not found that the repeated injections of killed S. only upon the problems of etiology but upon Sureus cultures would produce chronic nephritis those of therapy as well. in animals which had previously received a minute dose of uranium nitrate.
In our experiments with the B. mucosus cap THE BOY: A LAYMAN'S PSYCHOsulatus, however, the interesting fact was noted
ANALYSIS that the degree of chronic nephritis produced
GUY BOGART, Los Angeles, Cal. was not always dependent upon the number of
(DAVID BOBSPA) bacilli injected nor altogether upon the number (Perhaps a layman's ideas shouldn't creep into the of injections given. Animals show marked in- learned pages of the medical press. But as the son, dividual variations in their response to the bac
nephew and grandson of physicians, not to mention terial injections. A further intensive study of
an ancestry of medical and surgical men dating back
to the earliest colonial days, I feel a peculiar interest this problem of individual variations promises to in the journals of the profession.) aid in clearing up the etiology of chronic ne
With the coming of fatherhood many of the phritis. And here the old thought of trauma
problems of my own boyhood days have become combined with bacterial invasions recurs.
clearer. Father stands out in a clear light now. | O'Hara has shown that animals injected with Not that I have become suddenly wise; rather uranium nitrate and colon bacilli show far more damage in the kidneys than animals injected with colon bacilli alone. Here we have a chemical trauma added to bacterial infection, but it may be objected that uranium is a specific kidney poison and also that it rarely gets into the circulation of man or animal unless experimentally introduced.
Some evidence is, however, accumulating which suggests that a disturbed body metabolism may secrete toxins which damage the kidney. Every clinician knows the bad effect of an excessive protein diet in certain cases of chronic flephritis. Longcope has shown that the repeated injections of egg albumen in animals will produce chronic kidney lesions.
Salant has found that different diets cause marked changes in an animal's resistance to nephritis experimentally induced by certain chemicals. Thus, for example, he found that rabbits, when fed carrots resisted much larger doses of tartrates than did rabbits which received oats and cabbage. Also he found that carrots seemed to protect rabbits to some extent against doses of zinc malate. Ellinger has also found that cantharidin fails to cause nephritis in animals fed on a carrot diet.
The explanation of these interesting findings 15 still being sought. Salant suggests that the work of Metchnikoff and Wollman may offer a clue. These two workers found that indol form
my deepseated ignorance has been revealed. But early my wife and I decided that prophylaxis and hygiene are better than all other precautions. So Robert has passed through four and one-half years with but two direct passages with the surgeons-once when the stork needed the man of science to officiate at his function and later when the sidewalk proved harder than bones and tendons.
What a questioning little question mark these protean sparks of soul-stuff in growing humanstuff encased. I have expressed the wonder in my little
PROBLEM OF THE BOY.
Society approves the crime,
“Plus Environment." .
Here the problem, then,
The boy in the home. How he wins his was into the deepest roots of love. Do you recall, of course you do, such scenes as
HOLDING BOBBIE'S HAND
fingers you grasp,
Fame? Fortune? Who could care for them THE ROMANCE OF DR. AND MME. in exchange for the trinity of love in the rounded
ALEXIS CARREL home? For what would one give such price News from France of rare honors conferred less memories as that of
by the most distinguished savants of the republic
upon Madame the Marquise Anne Carrel, wife MY CALIFORNIAN
of the famous Franco-American surgeon, Dr.
Alexis Carrel, has brought to light one of the Sturdy little native son
most absorbing romances that ever proved the Of four,
old Spanish parable, “Genius without love is like In nightie, ready to sail The dream ship journey
a sun without warmth.” To the Sandman's palace,
In ancient Spain, where love bloomed as raGazed intent at colored map.
diantly as the luscious pomegranate, no wise man “This is Cal'fornia
was so highly honored by his disciples as that Where I was borned,"
one who had courted and won the most charmIn triumphant announcement;
ing senorita in his village. No wisdom, the And then,
philosopher declared, could be complete without "Was you, Muvver, and Daddy,
a knowledge of love's mysterious revelations. Borned in Cal'fornia, too?"
The romance of Dr. Carrel, the most famous Just Hoosier-born,
scientist the war has produced, and his beautiful We had to confess
marquise, has proven all over again that the
philosophy of ancient Spain is just as true today Our position
as then. Outside the pale of the elect. A puzzled look on
Almost everyone thinks of science as the
merciless foe of every kind of emotion. And That eager, earnest face, Then a smile.
hardly anyone who sponsors love would like to "But I had you, Daddy and Muvver,
have that erotic state of mind submitted to cold In Indiana.”
scientific analysis. Confession once again,
Yet almost everybody will admit that love is To that little
the geratest of all inspiration toward big achieveCalifornia lad.
ments, and the love which Dr. Carrel and his In Love's young honeymoon
talented wife found in their laboratory among “On banks of
the cultures and microscopes with which they The Wabash far away,"
courted science has proved their stepping stone, Full fruition had not come
their friends declare, to scientific greatness. To consecrate our altar.
Early in the war the world was electrified by Undaunted, undismayed,
reports of the marvelous advances in war surOur California sunbeam
gery by Dr. Carrel, who had gone to France from Quickly flashed
the Rockefeller institute. Triunphant answer:
Now Dr. Carrel declares that whatever his "But I wanted you,
successes have been, he and the world owe them Muvver and Daddy,
to the help given him by his beautiful young An' I cwied and cwied,
wife, Mme. Carrel, herself showered with honors An' you tame
few men have ever attained, pleads that her triAcross the desert
umphs merely are the fruition of her love for An' the mountains
her husband. Each has been the scientific as To get me in Cal'fornia."
well as the physical and sentimental complement
of the other. Together they have proven that President Frederic Burk of the San Fran- even science needs romance to make its triumphs isco State Normal School recently wrote me that possible. Robert is teaching you a great deal more than
In 1909 Dr. Carrel, then a young surgeon atou are teaching him.” This is true. What a tached to the clinic at the Rockefeller institute, esson for physician and layman alike for these in New York, first came to the notice of his proittle ones whose life star "cometh from afar” fession by performing one of the most dramatic ind "trailing clouds of glory from God which is operations in the history of surgery. As an exts home." Nearer to the original soul-stuff of perimentalist in the transfusion of blood he pod are these little ones, and well may we sit at watched with close attention developments in heir feet in worship. Let us be wise men today the case of the infant son of a brother physician ind take to the cradles of childhood precious whose blood had been exuded from the blood gifts of opportunity to live ever close to their vessels into the tissues of the body. od-hood and in communion with their soulself, Distinguished surgeons who were led into hat important part of life.
consultation were unanimous in the decision that
the child must die, the only remedy for such a complished. While the foremost surgeons of all condition being direct transfusion of blood, im- nations stood aghast he demonstrated by a series possible, they believed, in the case of so young a of remarkable operations, that the ailing heart, child.
for instance, of a patient whose affliction ordinDr. Carrel, learning of the outcome of the arily would have been pronounced incurable, consultation at midnight, telephoned the baby's might be removed from his body, treated sepafather and offered to try tansfusion. The father rately and replaced without destroying the paeagerly grasped at the desperate resort. Hastily tient's life. calling other surgeons, Dr. Carrel appeared at For this amazing demonstration Dr. Carrel once at the child's bedside and, using the father was granted the highest honor that can come to as the person to furnish the new blood, carried a member of his profession—the Nobel prize fot through successfully a delicate operation. The medicine. It made of him the world's most fachild became well and the young surgeon became mous surgeon. In 1913 he received the award famous.
of $39,000 which accompanies the prize, and then Madame Carrel was Anne de la Mott, a labo- it was he dared to ask his capable assistant at ratory student of the distinguished French sur- Lyons, the young marquise, to become his wife. geon, Tuffier, in the latter's hospital at Paris, Paris nodded its head with an “I told you so," when she married the Marquis de la Marie, a when the engagement was announced, but the patron of the arts. She continued her research blushing marquise declared "she had never work. She was the first French woman to win dreamed of such a thing” until the noted sura degree for proficiency in scientific bacteriologi- geon told her he wished to complete the joy his cal research.
Nobel prize had brought him by making its It was early in 1912 the young surgeon, Dr. money endowment the nest egg of a home. Carrel, whose work at the Rockefeller institute They were married in the holiday season of already had distinguished him as one of the 1913, the Rockefeller Institute granting Dr. Carforemost surgeons of the day, met the marquise, rel a six months' leave of absence for his honeywhose husband died soon after her marriage. moon. The wedding was in a little tumble-down Even then Dr. Carrel was working upon the church near the bride's home in the picturesque method of treatment for poison-producing French village, Bretagne. wounds, such as soldiers incur, which since has They traveled through Europe, visiting tobecome the greatest achievement of the century gether the great hospitals of Germany, Austria, in physical healing.
Italy and Russia, staying long enough at each He found the young widow continuing her to conduct new experiments and hold widely herexperiments in a Paris hospital. To him she was alded clinics at which Mme. Carrel was honored a beautiful example of splendid young woman- quite as much as her distinguished husband. hood devoting her life and energies to the dis. When Dr. Carrel returned to New York his covery of new ways to alleviate human suffer- bride remained in northern France for research ing. To her he was the great surgeon, success suggested by her husband. She was caught in ful, but still striving for greater triumphs-her the great onrush of the German invasion and, ideal of efficient, purposeful manhood.
retreating step by step with the French, she The hospital world in Paris detected the threw herself into the thick of the rescue and budding romance, although love had not yet been salvation work, organizing hospital staffs in the spoken of between the two young people whose very teeth of the advancing Germans. lives were devoted to the same cause. Dr. Carrel For her splendid fortitude and bravery she explained that the beautiful marquise was inter- was mentioned in army orders and decorated by ested in him only because of his work. She was the French commander-in-chief. sure, she told her friends, the promising young Dr. Carrel performed marvels of surgery in surgeon's attentions to her merely were a sign of the hospital at Compiegne which the French the interest of one scientist in the labors of an- government established for him. Here he made other.
the first extensive tests of his widely discussed When Dr. Carrel invited the marquise to be- method of filtering malignant bacteria from the come his laboratory assistant at his hospital at wounds of badly torn soldiers by a process of Lyons, which the French government had estab- irrigation. To his success made in this achieve lished for his experiments during his occasional ment is due the reconstruction of crippled mer visits to his native land, Paris was sure indeed into a semblance of their former selves. It 1 their scientific association eventually would be- one of the greatest epochal advances in the his come more sentimental.
tory of surgery. Late in 1912 Dr. Carrel again astounded the While her husband was directing clinics a medical world by proving that the long dreamed Compiegne Mme. Carrel went out to the bas of feat of transplanting human organs, such as and receiving hospitals to teach his methods ti the heart, kidneys or lungs, actually could be ac- the army surgeons at the front. Meanwhile sh