1
1653 medical practitioners. No practitioner will be entitled to recover any charges exceeding those in the tariff, "save in pursuance of any special agreement between the parties." It cannot be said that this tariff errs on the side of excess. It is very vague. "Any ordinary surgical operation, 10s."! 1 It is very doubtful, too, whether the Legislature is acting wisely in fixing fees. Practitioners who most respect them- selves will make their own terms. We shall be curious to know whether such a Bill becomes law. THE SEARCH FOR A CANCER PARASITE. THE contribution which Dr. Braithwaite makes to our columns this week adds one more to the list of investi- gations in the quest for the parasite which is assumed to be at the root of the most formidable class of diseases to which mankind is subject. The labours of histologists have shown that in their structure malignant growths are capable of being classified under certain well-defined groups, according to the type of tissue or organ in which they arise. But histology is silent as to the initial stimulus which gives rise to these aberrant cell masses, as well as to the remarkable potentialities with which ’hey seem to be endowed, so that recurrence in loco and general dissemination by the circulating fluids con- stitute a peculiar characteristic of malignancy. If in these : aspects malignant disease bears some resemblance to the Characters of tubercle, syphilis, and like infective disorders the analogy is purely superficial. For in every member of the class of infective disease the anatomical lesion is limited to the type of inflammatory or granulation tissue, and in none does it partake of the character of the more highly differentiated cells which are to be found in cancers and sarcomas. In the one case the influence of the microbe is confined to exciting changes, which we term" inflammatory," and the dissemination of the foci of disease is restricted to the territories in which the parasite finds a lodgment. If, then, I I cancer " (using the term in its widest sense) be also caused by a parasite it must of necessity be an organism which is endowed with quite special powers, for no histologist could declare that there was any real analogy between the processes of aberrant cell-growth in a malignant tumour and those of the small indifferent cells that constitute a tubercle or a gumma. Hence the failure of attempts to extract from malignant tumours by bacteriological methods any organisms of the bacterial class is hardly a matter for surprise. More hopeful of satisfactory result in this search would seem to have been the alleged discovery of cell parasites of protozoic nature ; but here, unfortunately, so far the only test that could be applied has been the morphological one, and in spite of the numerous and painstaking researches and the beautiful demonstrations of intra-cellular bodies which have been made it behoves us to be extremely cautious in accepting these bodies as the parasites in question. Similar caution is also needed in regard to the fungi which Dr. Braithwaite has found, and which apparently belong to the class of hypho- mycetes. The spores of such fungi abound in atmospheric dust, the readiness with which they germinate is notorious, and although Dr. Braithwaite assures us that he has found their mycelial threads penetrating the substance of neoplasms (recent and preserved) there i:. room for scepticism when it Þ is remembered that mould fungi are not infrequently found l mingling with tissues on the microscopic slide. Apart from any fallacy of this kind, however, it is well to recall that similar fungi have been found in the body-e. g., in the lungs-and have been introduced into it experimentally, with the result that they have either been quite innocuous or have merely excited some local inflammation. If Dr. Braithwaite’s inferences are correct, then the fungi he describes should show some peculiarities, according to the kind of malignant growth in which they occur, since it is not to be supposed that one and the same organism could excite the formation of a uterine myo-fibroma, an epithelioma, and a sarcoma. It would be interesting to learn the opinion of a botanist upon the fungus, for if this discovery be confirmed-and the research, as compared with that for the protozoal parasite, is simplicity itself-quite a new light will have been thrown on the role of parasitic fungi. SWALLOWING A DENTURE. THE dangers of the custom prevalent with some people of going to sleep without removing artificial teeth have been illustrated in a striking manner by a case reported by Mr. J. Maxwell Wood in the British Journal of Dental Science. A servant girl aged eighteen went to sleep wearing a plate measuring 1$in. by lin., the attachments being two short gold bands. In the morning the plate was nowhere to be found, and later in the day the advent of a pain in the stomach convinced the owner of the plate that she had swallowed it. On confiding her case to her mistress that lady at once sent for the family medical man, and also, with more zeal than judgment, gave the girl a large dose of castor oil. On the medical man arriving he found that the plate had been passed within an hour of the taking of the oil. That the patient had a very narrow escape both from her accident and its treatment is obvious. Probably she suffered from the usual complaint of her class, chronic constipation, and thus the purgative effects of the oil would do far less mischief than in a case where it would have brought about liquefaction of the fasces. LIFE INSURANCE OF CHILDREN. THE withdrawal of Sir Richard Webster’s Bill for the regulation of children’s insurances does not of course imply either its abandonment or any distrust of the principles upon which it is founded. It is evidence merely of a laudable desire on the part of its author to ensure the permanent utility of his measure by allowing further time for the full consideration of all trade interests which might be affected by it. Despatch in this kind of business is best ensured by careful slowness at its beginning, even though the main features of the Bill may not call for material alteration. Some modification of its terms may, however, be desirable. In its present form it might in the minds of some not too friendly critics appear to suggest an unintended preference for workmen’s benefit societies as compared with other more purely commercial companies. However this presentation of the case may express the practieni result of inquiries into the use and abuse of this class of insurances, we are certain that no such direct espousal of a party interest was ever contemplated. What is in- tended is to so guard the method of insurance against possible abuses that it shall best fulfil the purpose for which it was instituted. We are aware that a distinction must in all cases be drawn between real and supposed causes and effects, and we will not deny that an understood connexion between infant mortality and loosely regulated systems of in- surance may not constitute proof in a legal sense. After making every allowance, however, it is impossible to regard otherwise than with strong suspicion the fact that in many causes fatal neglect of children by drunken or vicion..

THE SEARCH FOR A CANCER PARASITE

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1653

medical practitioners. No practitioner will be entitled torecover any charges exceeding those in the tariff, "save inpursuance of any special agreement between the parties."

-

It cannot be said that this tariff errs on the side of excess.It is very vague. "Any ordinary surgical operation, 10s."! 1It is very doubtful, too, whether the Legislature is actingwisely in fixing fees. Practitioners who most respect them-selves will make their own terms. We shall be curious toknow whether such a Bill becomes law.

THE SEARCH FOR A CANCER PARASITE.

THE contribution which Dr. Braithwaite makes to ourcolumns this week adds one more to the list of investi-

gations in the quest for the parasite which is assumedto be at the root of the most formidable class of diseasesto which mankind is subject. The labours of histologistshave shown that in their structure malignant growthsare capable of being classified under certain well-defined

groups, according to the type of tissue or organ in which

they arise. But histology is silent as to the initial

stimulus which gives rise to these aberrant cell masses,as well as to the remarkable potentialities with which’hey seem to be endowed, so that recurrence in loco

and general dissemination by the circulating fluids con-

stitute a peculiar characteristic of malignancy. If in these: aspects malignant disease bears some resemblance to theCharacters of tubercle, syphilis, and like infective disordersthe analogy is purely superficial. For in every member ofthe class of infective disease the anatomical lesion is limitedto the type of inflammatory or granulation tissue, and innone does it partake of the character of the more highlydifferentiated cells which are to be found in cancers andsarcomas. In the one case the influence of the microbe isconfined to exciting changes, which we term" inflammatory,"and the dissemination of the foci of disease is restricted tothe territories in which the parasite finds a lodgment. If,then, I I cancer " (using the term in its widest sense) be alsocaused by a parasite it must of necessity be an organismwhich is endowed with quite special powers, for no histologistcould declare that there was any real analogy between theprocesses of aberrant cell-growth in a malignant tumour andthose of the small indifferent cells that constitute a tubercleor a gumma. Hence the failure of attempts to extract frommalignant tumours by bacteriological methods any organismsof the bacterial class is hardly a matter for surprise. More

hopeful of satisfactory result in this search would seem tohave been the alleged discovery of cell parasites of protozoicnature ; but here, unfortunately, so far the only test thatcould be applied has been the morphological one, and in

spite of the numerous and painstaking researches and thebeautiful demonstrations of intra-cellular bodies which havebeen made it behoves us to be extremely cautious in acceptingthese bodies as the parasites in question. Similar caution isalso needed in regard to the fungi which Dr. Braithwaite hasfound, and which apparently belong to the class of hypho-mycetes. The spores of such fungi abound in atmosphericdust, the readiness with which they germinate is notorious,and although Dr. Braithwaite assures us that he has foundtheir mycelial threads penetrating the substance of neoplasms(recent and preserved) there i:. room for scepticism when it

Þ is remembered that mould fungi are not infrequently foundl mingling with tissues on the microscopic slide. Apart from

any fallacy of this kind, however, it is well to recall thatsimilar fungi have been found in the body-e. g., in the

lungs-and have been introduced into it experimentally, withthe result that they have either been quite innocuous or havemerely excited some local inflammation. If Dr. Braithwaite’sinferences are correct, then the fungi he describes shouldshow some peculiarities, according to the kind of malignantgrowth in which they occur, since it is not to be supposedthat one and the same organism could excite the formationof a uterine myo-fibroma, an epithelioma, and a sarcoma.It would be interesting to learn the opinion of a botanistupon the fungus, for if this discovery be confirmed-and theresearch, as compared with that for the protozoal parasite, issimplicity itself-quite a new light will have been thrownon the role of parasitic fungi.

SWALLOWING A DENTURE.

THE dangers of the custom prevalent with some people ofgoing to sleep without removing artificial teeth have beenillustrated in a striking manner by a case reported by Mr. J.Maxwell Wood in the British Journal of Dental Science. Aservant girl aged eighteen went to sleep wearing a platemeasuring 1$in. by lin., the attachments being two shortgold bands. In the morning the plate was nowhere to befound, and later in the day the advent of a pain in thestomach convinced the owner of the plate that she hadswallowed it. On confiding her case to her mistressthat lady at once sent for the family medical man,and also, with more zeal than judgment, gave the

girl a large dose of castor oil. On the medical man

arriving he found that the plate had been passed within anhour of the taking of the oil. That the patient had a verynarrow escape both from her accident and its treatment isobvious. Probably she suffered from the usual complaint ofher class, chronic constipation, and thus the purgative effectsof the oil would do far less mischief than in a case where itwould have brought about liquefaction of the fasces.

LIFE INSURANCE OF CHILDREN.

THE withdrawal of Sir Richard Webster’s Bill for the

regulation of children’s insurances does not of course implyeither its abandonment or any distrust of the principles uponwhich it is founded. It is evidence merely of a laudabledesire on the part of its author to ensure the permanentutility of his measure by allowing further time for the fullconsideration of all trade interests which might be affectedby it. Despatch in this kind of business is best ensured bycareful slowness at its beginning, even though the mainfeatures of the Bill may not call for material alteration.Some modification of its terms may, however, be desirable.In its present form it might in the minds of somenot too friendly critics appear to suggest an unintendedpreference for workmen’s benefit societies as comparedwith other more purely commercial companies. Howeverthis presentation of the case may express the practieniresult of inquiries into the use and abuse of this classof insurances, we are certain that no such direct espousalof a party interest was ever contemplated. What is in-tended is to so guard the method of insurance against possibleabuses that it shall best fulfil the purpose for which it wasinstituted. We are aware that a distinction must in allcases be drawn between real and supposed causes and effects,and we will not deny that an understood connexion betweeninfant mortality and loosely regulated systems of in-surance may not constitute proof in a legal sense.

After making every allowance, however, it is impossible toregard otherwise than with strong suspicion the fact that inmany causes fatal neglect of children by drunken or vicion..