Final report of the Royal Commission on Vivisection.

  • Great Britain. Royal Commission on Vivisection (1906)
Date:
1912
Catalogue details

Licence: Public Domain Mark

Credit: Final report of the Royal Commission on Vivisection. Source: Wellcome Collection.

    138/158 (page 126)
    Martin, 12026. 12028. 12356. 126 serum-treated cases. But from a continuous study of reports and other sources of information bearing on the subject, I obtained knowledge of the existence of at least one hospital in which some cases were treated with anti-toxin and others were not, in accordance with the diverse opinions as regards serum treatment which were held the aggregate, unselected. The hospital to which I refer was the Toronto Hospital, Canada. I accordingly wrote to the Medical Officer of Health of Toronto City for infor- mation on the subject, and he kindly supplied me with a copy of his annual report for 1904. In my further examination of Dr. Martin, I submitted excerpts from this report which appear in the evidence, but which he very properly declined to accept without examination. I deem them, however, to be of such importance that I feel justified in giving them here, merely premising that the few interpellations connecting the several excerpts from the report are mine, but I vouch for the accuracy of the excerpts. The excerpts are as follows :— “Since 1894, when the first dose of antitoxin was given at the hospital, the mortality results have almost always been unfavourablé. In every year, save one, the percentage of deaths in anti-toxin cases has even been higher than the ordinary hospital rate,which is of course influenced by the increased anti-toxin mortality. In 1894 the figures were respectively 21-4, against 14-07, and this state of things continued without much improvement until 1902, when the anti-toxin was about 1 per cent under the gross hospital rate.” Then he gives the statistics for 1903 :— Cases. Deaths. Per Cent. Total hospital admissions - - 565 65 11-5 Anti-toxin treatment = - : < 228 37 16-2 Ordinary treatment . - - 337 28 8:3 But then he goes on to observe: “ The statistics of the last decade, which can now be presented, embrace a sufficient number of cases on which to base a fair opinion of the value of anti-toxin in hospital practice. Cases. Deaths. Per Cent. Total hospital admissions - - 5,100 667 13-0 Anti-toxin treatment - - - 1,132 181 16-0 Ordinary treatment = - - 3,968 486 12-2,” - And then he says: “In a report of this kind any speculations as to the cause of the pronounced failure of a remedy from which so much was expected would probably be deemed out of place. A bare statement of fact is therefore presented, and this can, if necessary, be supplemented or substantiated by a large accumulation of original and classified evidence of unquestionable reliability.” Do you accept that report ?— Not without examination. It will be seen from the above extracts that while doubts were entertained by the staff of the Newcastle Isolation Hospital as to the relative value of the serum treatment, the experience of the Toronto Hospital during the decade succeeding the introduction of the treatment goes to prove that in the aggregate patients suffermg from diphtheria would have a better chance of recovery were no serum used. In reply to other questions, Dr. Martin stated that he would always recommend its use as a prophylactic in every. household in which a case of diphtheria cropped up, and he further stated it as his opinion that if a patient in the early stage of the disease, received a dose of anti-toxin, no matter of what intensity the infection might be, the case would not prove fatal. Surely no experiments on animals could ever inspire a larger hope or more assured confidence than is contained in these two statements. Tetanus. This disease as stated in the Report (Paragraph 56) is admittedly an infectious disease under certain conditions, and as the usual habitat of the assumed casual agent, the tetanus bacillus, is polluted soil, and especially soil polluted with horse-dung, or road dust containing particles of horse-dung, the disease constitutes a remarkable exception to the theory that infectious diseases do not originate de novo. It is noteworthy too, that though wounds are common, and abrasions from falls on dusty roads are common, cases of tetanus are extremely rare. As already stated, the serum has fallen into disrepute as a remedy, but before it was given up altogether, there were some surgeons who possessed the reckless daring of trephining the skull of the patient, and injecting it under the dura mater into, or on to, the brain substance just because the. treatment had failed when the serum was injected subcutaneously. . And, here, I may be permitted to say, in passing, that this surely is a very significant instance of Professor Starling’s famous dictum,—‘ The final experiment must always be made on man.”