therapeutic ANIMAL
EXTRACTS
IN
IRotes.
THERAPEUTICS.
This
subject was recently discussed at the section of Pharmacology at the British Medical Association Meeting at Aberdeen. Thyroid extract was not included in the discussion, though allusions to it occasionally crept in, as it was thought that the
great
mass
of this substance
sitting
of evidence
was
too
large
now
accumulated
to be dealt
with,
on
the action
unless
a
whole
could be devoted to it alone.
Professor Noel Paton, who
opened
the
discussion, pointed
many difficulties and fallacies which surround the interpretation of experimental and clinical data on the action out the
of animal extracts, and his paper, when it appears, should be
carefully
read
by clinicians,
as
it is
who may be led to draw too definite from their
own
observations,
a or
valuable
warning
to all
far-reaching conclusions
from those which appear in the For his task Professor Noel Paton
or
already extensive literature. was admirably fitted, as he has recently devoted considerable attention to the subject, and his conclusions, coming from a pure physiologist, are less likely to be biassed than those
THERAPEUTIC
25? which
drawn
are
NOTES.
by pharmacologists
or
physicians.
Among
the many difficulties and fallacies which may arise he called
attention to the
following
(1) Nucleo-proteins occurring
:
in
animal extracts may be missed in the process of extraction, and their active part in contributing to the physiological effect overlooked ;
(such
choline
as
pharmacological "
(2) early putrefaction the
or
"
of the organ ;
well known to do in the method of
the action of
"
specific
may introduce animal extract, as it is
(3) dosage an
vegetable drugs ; (4) the so-called very difficult to employ in demon-
of
case
antagonism
bodies
with distinct
action, which may be attributed to the
internal secretion
much variation into the action of "
produce
may
putrefactive amines)
is
internal secretion.
strating Again, speaking generally, of
an
internal secretion is
determine. action
on
the pancreas,
section of the
part
an
Thus adrenalin
Its action
removed.
the
an
on
as
the mode and place of action extraordinarily difficult thing to cannot produce glycosuria by its
it is effective after that organ is peripheral, as it occurs after
must be
splanchnics.
The liver has been
suggested
as
which it acts, but this view is also difficult to
Apparently the action of internal secretions is specific, and not merely a general metabolic effect, but considerable variations occur in the specificity owing to differences in the physiological sensitiveness of the same organ, both at different periods of its development and as it occurs in different animals. Professor Noel Paton considers that the specificity of extracts has been much exaggerated, and condemns in toto elucidate.
the as
use
of advertised mixed extracts, which
the worst form of
word
"
hormone
"
as
polypharmacy. a
general
he
He also
characterises
objects to the principles
term for the active
implies stimulation, whereas inhibitory. principles Dr. Griinbaum, who spoke next, reinforced the very necessary words of caution as to the interpretation of results which the first speaker had uttered. Passing on to the con-
of internal secretions. many of these
Hormone are
sideration of individual extracts, he said that he had fed number of persons between the ages of 16 and
a
18, whose growth
THERAPEUTIC NOTES.
below normal,
was
medulla,
on
on
suprarenal
the other hand
was
251
cortex, without result.
useful in three ways
The
(1)
:
In
the diagnosis of Addison's disease ; (2) to tide over temporary suprarenal inadequacy, as after an injection of salvarsan ; (3) continuously in large doses (40 to 60 minims three times a day) in Addison's disease. In hsematemesis a few minims every hour for 24 hours might be useful, but at longer intervals it did no good. In haemophilia he had found it useless. extract he had tried in two cases of paralysis agitans Parathyroid without result. Pituitary extract he found might be used to raise the blood pressure temporarily, but repeated injections In two cases of adiposis dolorosa he had seen were valueless. occur with large doses, but the remedy was costly. improvement he extract did not consider of practical value, and Kidney doubted the theoretical grounds on which its employment in nephritis was advocated. Hormonal he had used with appreciable results in chronic constipation, but he was inclined to attribute much of its effect to suggestion, the intramuscular injection of this substance being very painful. Dr. Hertz, dealing first with adrenalin, advocated its use in very small doses, usually | minim, and never more than 1 \ minim, subcutaneously to relieve the spasmodic attacks He gave details of his
in asthma.
broncho-dilator, and
to act as a
doses,
even
of
He
cured
Dr.
were
pointed not
a
night,
a
Parathyroid
and like Dr.
curious
case a
of definite
goitre,
the
blood-vessels,
that all
due to
contract
had
no
and
act or
close
in
excess
one
on
the
stimulant action
which
doses of the extract.
out
of
heightened blood suprarenin. He doubted
cases
of
pressure if the action of this substance varied with the dose.
intestine it may
could
extract in ten
Griinbaum, had obtained
after the removal of
by continuous
Gunn
He believed it
case.
three times in
related, however,
parathyroid insufficiency was
or
He had tried
paralysis agitans,
results.
no
two
repeated
atheroma.
produce cases
when
own
did not think that these small
the
of two
ways?either directly on making it Experimentally pituitrin
muscularis mucosae,
vessels. on
On the
the heart, and it
was
very difficult
LI
252
BRAKY.
to show that it had any action ever, it motor
on
might act by making impulses.
the isolated intestine.
the
muscle
more
How-
sensitive
nerve
J.
M. Fortescue-Brickdale.
to
EXTRACTS
IN
IRotes.
THERAPEUTICS.
This
subject was recently discussed at the section of Pharmacology at the British Medical Association Meeting at Aberdeen. Thyroid extract was not included in the discussion, though allusions to it occasionally crept in, as it was thought that the
great
mass
of this substance
sitting
of evidence
was
too
large
now
accumulated
to be dealt
with,
on
the action
unless
a
whole
could be devoted to it alone.
Professor Noel Paton, who
opened
the
discussion, pointed
many difficulties and fallacies which surround the interpretation of experimental and clinical data on the action out the
of animal extracts, and his paper, when it appears, should be
carefully
read
by clinicians,
as
it is
who may be led to draw too definite from their
own
observations,
a or
valuable
warning
to all
far-reaching conclusions
from those which appear in the For his task Professor Noel Paton
or
already extensive literature. was admirably fitted, as he has recently devoted considerable attention to the subject, and his conclusions, coming from a pure physiologist, are less likely to be biassed than those
THERAPEUTIC
25? which
drawn
are
NOTES.
by pharmacologists
or
physicians.
Among
the many difficulties and fallacies which may arise he called
attention to the
following
(1) Nucleo-proteins occurring
:
in
animal extracts may be missed in the process of extraction, and their active part in contributing to the physiological effect overlooked ;
(such
choline
as
pharmacological "
(2) early putrefaction the
or
"
of the organ ;
well known to do in the method of
the action of
"
specific
may introduce animal extract, as it is
(3) dosage an
vegetable drugs ; (4) the so-called very difficult to employ in demon-
of
case
antagonism
bodies
with distinct
action, which may be attributed to the
internal secretion
much variation into the action of "
produce
may
putrefactive amines)
is
internal secretion.
strating Again, speaking generally, of
an
internal secretion is
determine. action
on
the pancreas,
section of the
part
an
Thus adrenalin
Its action
removed.
the
an
on
as
the mode and place of action extraordinarily difficult thing to cannot produce glycosuria by its
it is effective after that organ is peripheral, as it occurs after
must be
splanchnics.
The liver has been
suggested
as
which it acts, but this view is also difficult to
Apparently the action of internal secretions is specific, and not merely a general metabolic effect, but considerable variations occur in the specificity owing to differences in the physiological sensitiveness of the same organ, both at different periods of its development and as it occurs in different animals. Professor Noel Paton considers that the specificity of extracts has been much exaggerated, and condemns in toto elucidate.
the as
use
of advertised mixed extracts, which
the worst form of
word
"
hormone
"
as
polypharmacy. a
general
he
He also
characterises
objects to the principles
term for the active
implies stimulation, whereas inhibitory. principles Dr. Griinbaum, who spoke next, reinforced the very necessary words of caution as to the interpretation of results which the first speaker had uttered. Passing on to the con-
of internal secretions. many of these
Hormone are
sideration of individual extracts, he said that he had fed number of persons between the ages of 16 and
a
18, whose growth
THERAPEUTIC NOTES.
below normal,
was
medulla,
on
on
suprarenal
the other hand
was
251
cortex, without result.
useful in three ways
The
(1)
:
In
the diagnosis of Addison's disease ; (2) to tide over temporary suprarenal inadequacy, as after an injection of salvarsan ; (3) continuously in large doses (40 to 60 minims three times a day) in Addison's disease. In hsematemesis a few minims every hour for 24 hours might be useful, but at longer intervals it did no good. In haemophilia he had found it useless. extract he had tried in two cases of paralysis agitans Parathyroid without result. Pituitary extract he found might be used to raise the blood pressure temporarily, but repeated injections In two cases of adiposis dolorosa he had seen were valueless. occur with large doses, but the remedy was costly. improvement he extract did not consider of practical value, and Kidney doubted the theoretical grounds on which its employment in nephritis was advocated. Hormonal he had used with appreciable results in chronic constipation, but he was inclined to attribute much of its effect to suggestion, the intramuscular injection of this substance being very painful. Dr. Hertz, dealing first with adrenalin, advocated its use in very small doses, usually | minim, and never more than 1 \ minim, subcutaneously to relieve the spasmodic attacks He gave details of his
in asthma.
broncho-dilator, and
to act as a
doses,
even
of
He
cured
Dr.
were
pointed not
a
night,
a
Parathyroid
and like Dr.
curious
case a
of definite
goitre,
the
blood-vessels,
that all
due to
contract
had
no
and
act or
close
in
excess
one
on
the
stimulant action
which
doses of the extract.
out
of
heightened blood suprarenin. He doubted
cases
of
pressure if the action of this substance varied with the dose.
intestine it may
could
extract in ten
Griinbaum, had obtained
after the removal of
by continuous
Gunn
He believed it
case.
three times in
related, however,
parathyroid insufficiency was
or
He had tried
paralysis agitans,
results.
no
two
repeated
atheroma.
produce cases
when
own
did not think that these small
the
of two
ways?either directly on making it Experimentally pituitrin
muscularis mucosae,
vessels. on
On the
the heart, and it
was
very difficult
LI
252
BRAKY.
to show that it had any action ever, it motor
on
might act by making impulses.
the isolated intestine.
the
muscle
more
How-
sensitive
nerve
J.
M. Fortescue-Brickdale.
to
