The Harveian Lectures on prognosis and treatment in pulmonary tuberculosis : delivered before the Harveian Society of London on November 1st, 8th, and 15th, 1900 / by Robert Maguire, M.D.

  • Robert Maguire
Date:
1900
Catalogue details

Licence: Public Domain Mark

Credit: The Harveian Lectures on prognosis and treatment in pulmonary tuberculosis : delivered before the Harveian Society of London on November 1st, 8th, and 15th, 1900 / by Robert Maguire, M.D. Source: Wellcome Collection.

Provider: This material has been provided by the Harvey Cushing/John Hay Whitney Medical Library at Yale University, through the Medical Heritage Library. The original may be consulted at the Harvey Cushing/John Hay Whitney Medical Library at Yale University.

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    in clinical use. I tried the addition to the solution of such a small amount of perchloride of mercury as would probably act as a germicide. This precipitated the diastase in a few hours, but adding it shortly before the injection I managed to get a solution which would keep for a short time in the fluid condition and this I tried, without ill effect, upon rabbits. Later, Messrs. Squire and Sons prepared for me a fairly permanent solution of taka-diastase made with tri-cresol as the antiseptic, and afterwards with formic aldehyde in the strength of 1 in 250,000. This I tried upon patients with the view of thera- peusis which I have mentioned. I injected 30 minims— that is, two cubic centimetres—at intervals of four days. But the immediate result of the injection (a result which appeared in about half an hour afterwards) was rigor, pyrexia, and sweating; in fact, an exact imitation of an ague attack. The pyrexia reached to the height of about 102° or 103° F. and afterwards the patients felt much better ; certainly they took food more freely and there could be no doubt of some improvement in the condition both gene- rally and as judged by the physical signs of the chest. Yet there was not so great an improvement as to encourage me to pursue the treatment. Mr. Horace Brown, F.R.S., so well known for his researches on diastasic zymes, very kindly gave me his advice on the question under discussion and suggested that I should try the effect of cytase, such as he had obtained from freshly crushed oats. He has shown, and has described in his published papers, that this substance is very powerful in digesting the cellulose envelope of cereals. I show you here a solution of cytase which bas been prepared for me by Mr. Peter Squire in a form which might be used for intra- venous injection, and the solution I have found to have a very definite solvent action even upon cotton-wool. Again, you see under the microscope two sections of barley. One has been treated with a solution of formic aldehyde alone— that is, with an antiseptic ; the other with the same reagent, but also with cytase, and the latter specimen shows a marked solution of the cellulose envelope of the grain, while the former appears to be intact. We would like to get the same solution of the tubercle bacillus in the lung, but, unfortunately, the reaction is very slow and is likely to be greatly interfered with by dilution in the process of intravenous injection. I have obtained the solution of cytase which I show you only within the last few days. I will certainly try its effects, for possibly one may be able to hasten its action. In the last lecture I mentioned the surprising effects which I had obtained by administering nuclein by the mouth in the treatment of such tuberculous glands as could not be removed by operation. I tried nuclein given thus, upon patients suffering from tuberculosis of the lungs, and with- out the slightest effect. The idea, of course, is that the nuclein will so strengthen the leucocytes as better to enable
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