Appendix to Second report of the Commissioners : minutes of evidence, February to March, 1907.
- Great Britain. Royal Commission on Vivisection (1906)
- Date:
- 1907
Licence: Public Domain Mark
Credit: Appendix to Second report of the Commissioners : minutes of evidence, February to March, 1907. Source: Wellcome Collection.
36/104 (page 30)
![Cushny, M.A., M.D. 96 Feb. 1907. 30 knowledge of the results which it produces ?—Yes, a scientific knowledge in regard to the action of a drug may indicate further uses for it. 4969. If we had simply depended on clinical know- ledge we should say, “This drug makes this patient well,” and therefore we would use it on the next pa- tient ?—That is exactly what has happened for cen- turies and centuries until this last century. 4970. But we do not know in the least from that how it acts—through what means it acts, do we ?— Very seldom. 4971. Neither is it possible, on a sick person, is it, to apply scientific instruments to see whether the blood pressure is altered, and how much? It is pos- sible, perhaps, to keep a register of the temperature from hour to hour, but even that is distressing to the patient more or less, is it not ?—It is quite impossible to make most scientific investigations in that way. 4972. Now, with regard to the use of digitalis, of which a great deal has been said to-day, you men- tioned its use in pneumonia ; but is there not another disease in regard to which our present knowledge of ance? Would it be good treatment now, according to our present knowledge, to give digitalis in cases of apoplexy ?—Certainly not. 4975. Formerly, was it very much used for apo- plexy 7—Yes. 4974. Of course, its tendency would be to increase the hemorrhage ?—Yes. 4975. And that is what you wish to avoid ?—Yes. 4976. Therefore it would now almost be considered malpractice to give digitalis in cases of apoplexy ?— Yes. I might have added apoplexy to aneurism in my statement. Uf I had put apoplexy and aneurism it would have been all right, 4977. You only mentioned lead and opium, I pre- sume, as an instance ?—Yes, only as an instance. 4978. Because as a matter of fact, of course, a great many people never used lead for pulmonary heemor- rhage for years and years before you mentioned it ?— A great many use it at the present day. 4979. But a great many did not then?—Yes. I did not mean to cast any reflection upon the profession, of course. 4980. With regard to local anesthetics and anes- thesia, do not you think there is a great future for local] anesthesia yet ?—I think its uses are not by any means exhausted yet. 4981. But, even with such local ansesthetics as we are now acquainted with, is it not the case that what may be called quite major operations are now being performed ?—Yes, and they have been for 10 years. T think every operation that I know of is being per- formed under local anesthesia now, and its use, of course, is always extending. 4982. And there can be little doubt that local anes- thesia is safer than general anesthesia ?—It has many advantages besides being safer. It is safer in many ways. 4983. There is always risk of death, is there not, under general anesthesia ?—Yes. 4984. And the probability is that as our knowledge of local anesthetics improves, they will become more and more useful ?—Yes. 4985. I know you are not in practice, but could you tell the Commission some of the most formidable operations which are at the present moment done with local anesthetics?—Almost any operation has been done. The abdominal cavity, for example, is opened, the ovaries are removed, the intestine is sutured, and amputations of legs and arms have been performed under them. 4986. I have in my mind especially those abdominal operations ?—Yes, they are quite frequent. 4987. Are they a sample of what you may call severe Serious operations that are done every day now with local aneesthetics ?—Yes. 4988. How is it that the patients do not suffer tor- ments from their intestines and abdomens and other organs in the abdomen being handled ?—Bezause the evidence goes to show that the intestine and other abdominal organs have really very little ordinary sensation of pain. | 4989. Is it probable that the abdominal organs and intestines of other animals than man are more sensi- tive ?—Not at all. 4990. Just one question with regard to antipyretics. I do not quite agree with one statement you made. I do not think I quite understood you. You com- menced by saying that until 1870 the only reliable means of combating fever temperature was quinine. You do not really mean that, surely ?—Perhaps I should have said the only reliable drug. 4991. That is very different ?—Yes. refers exclusively to drugs practically. have said drug. 4992. I would not take exception to drugs, but I did take exception to that statement ?—Of course. 4993. Cold is a much greater one ?—Yes. 49934. And in the same way I do not know that I quite understand your statement about cardiac tonics. You say that several other cardiac tonics have been introduced into therapeutics and have had more or less vogue—helleborus niger, convallaria, etc. But those have not been introduced since stropanthus or since pharmacology ?—No. 4994. What you really mean is that their true action and the active principles in them have been investi- gated ?—Yes. Of course helleborus in particular is a very ancient drug. I really mean their active con- stituents. 4995. Both of them have been used since classical times ?—Yes. 4996. What you mean is that in the case of those drugs no one knew exactly how they acted ?—Exactly. 4997. Or what was the active principle in them ?— No. 4998. We have heard a great deal in this room about curare, and I should like to ask you some few questions as to it. It is accepted as a maxim, I might say, that it paralyses the voluntary muscles and does not affect sensation ; that has been the ordinary belief of the lay mind—they have accepted that as the result of the last Royal Commission, which de- cided that it should not be used as an anesthetic ?— Any ordinary dose of curare, any ordinary amount. of curare, such as is used to throw the muscles out of action, I think, has not any effect at all upon the central nervous system to paralyse sensation. What is the effect in very large doses, I think, is not quite determined. 4999. Is it the case that some of those who were best acquainted with drugs of that sort doubted whether Claude Bernard’s statement was absolutely true at the time when it was, we will not say accepted by the Commission, but at the time they acted upon it?— I should like the statement to be more definitely before me. 5000. Do you agree with what Sir Lauder Brunton said when he was examined? The question was put to him: “ We have had a great deal of evidence before us showing difference of scientific opinion as to whether it (that is curare) is an anesthetic, but, on the whole, the balance of evidence, in the view of Claude Bernard, seems to show that while it stops muscular motion it does not banish pain”; and Sir Lauder Brunton said : “T think Claude Bernard is mistaken.” Then he goes on to explain, and say very much the same as you do —that he thinks it is a matter possibly of the quantity, and he goes into the matter at greater length than I need; but I should like to know whether your opinion is that we have positive evidence that in small doses it only acts as a paralyser ?—Yes. 5001. And you do not think we have positive evi- dence that in large doses it acts as an anesthetic ?— We have not positive knowledge as to what effect very large doses produce. My evidence I ought to 5002. So that yeu have no special information that you can give us on that point?’—TI think there can be no doubt that with small doses it is not an anesthetic. 5003. I ought, perhaps, to put this question to a physiologist rather than to you, but do you know whether curare is much used by experimenters in this country ?—I do not think it is much used any- where. To tell the truth, it is very difficult to get, and the reason why I refuse to give any definite state- ment as to curare is that it is so indefinite. We have not the same curare that we could have got thirty or](https://iiif.wellcomecollection.org/image/b3218217x_0036.jp2/full/800%2C/0/default.jpg)
