Appendix to First report of the Commissioners : minutes of evidence, October to December, 1906.

  • Great Britain. Royal Commission on Vivisection (1906)
Date:
1907
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Licence: Public Domain Mark

Credit: Appendix to First report of the Commissioners : minutes of evidence, October to December, 1906. Source: Wellcome Collection.

    148/164 (page 142)
    Starling, M.D., F.R.S. 20 Dee. 1906. 142 4093. Then I will not trouble you about it. Can you give us any instances (you have given one or two) in which research has directly led to the dis- covery of a drug, or a method of treatment, which has undoubtedly largely benefited mankind. We have the case of the anti-diphtheritic toxin, for in- stance ?—Professor Cushny will give evidence on drugs. He will show that every modern drug in our Pharmacopeia, with the exception of pilocarpin, which is not much used, has been introduced as the result of experiments on living animals. 4094. (Dr. Gaskell.) You were asked yesterday by Sir William Collins whether our knowledge was com- plete as to the nature of the anterior and posterior roots in consequence of the work of Bell and Magen- die, the one set of roots being sensory and the other motor ?—Yes. 4095. Since that time there has been much more knowledge acquired, has there not, as to the nature of the nerve fibres in both these roots ?—Yes. 4096. And you could hardly say now, could you, that our knowledge is complete ?—No, there is still a good deal to be discovered. There are still many difficulties with regard to the fibres and their course, and the origin of the fibres making up both the an- terior and posterior roots. 4097. I think one might take it, perhaps, that so far as the motor or anterior roots are concerned, we have found out a large number of different kinds of nerves since the time of Bell and Magendie—vaso motor nerves, pilo motor nerves, and so on ?—Yes. 4098. Can we say the same to the same extent of the sensory roots—the posterior roots?—No, I think that the constitution of the posterior roots is still a matter on which we know that we do not know. We now that there must be a multiple constitution of these roots, but we do not understand the origin and source of the fibres which make up these roots. 4099. We also do not know the different kinds of fibres in those roots as well as we do in the motor roots, that is to say, the fibres subservient of sensa- tion of different kinds?—That is so. 4100. May I take it that every single nerve possesses sensory or afferent fibres, as well as motor or efferent tibres ?—Probably every single nerve possesses fibres which carry impulses towards the central nervous system ; but it does not necessarily follow that all these fibres carry sensation to the brain. 4101. I was coming to that. Therefore, every in- ternal organ, like the liver and other internal organs, possesses afferent or sensory fibres ?—Yes. 4102. And yet you said yesterday that there was no pain in many of these organs when they were io some extent stimulated ?—No, that is so. 4103. Would you tell the.Commission how it comes about that if they possess sensory fibres, yet there is no pain? Are we to consider that the nerves which absorb pain are a separate category from such nerves as give a feeling of nausea, for instance, or give a feeling of micturition, or of cold, or of heat, or a sactile sensation; or are we to suppose that all the sensory nerves are capable of causing pain?—I think there is no doubt that the pain sense is bound up with the existence of a special class of nerves, and that these pain nerves may be absent from an organ, although many other kinds of sensory fibres are pre- sent in that organ. \ 4104. And in these internal organs, so far as one knows, the pain neryes are absent ?—In some of them. In the intestine, for instance, you get pain of a peculiar kind. 4105. These special pain nerves are specially found in the skin, are they not ?—Yes, it is the skin which is especially the sensitive part, and from which most of the phenomena of the sensations of pain are aroused. In most operations the painful part of the operation is the skin incision. 4106. So that, if the skin is treated aseptically, then the healing process is not accompanied by pain? No; it ought to be quite free from pain. 4107. And if the internal orgsns are treated asep- tically during the operation, and healed aseptically afterwards, there ought to be no pain in them? No ; there shoull ‘be no pain, and an ordinary exposure of an internal organ would not cause any impressions of pain, even in the course of the operation. * 4108. But if there is inflammation, there may be pain ?—Then there may be pain. } 4109. Could you explain to the Commission in what way that aseptic treatment prevents the sensation of pain ?—When a wound is ordinarily made, say, in the skin, and is exposed to infection by micro-organisms, we get injury of the vessels and tissues surrounding the.wound. ‘This injury causes swelling of the tissues and, therefore, pressure on the nerves running through these tissues, and, therefore, sensations of tenderness and pain. If, by proper cleansing of the skin, and of the instruments used, we prevent the access of micro-organisms to the wound, then the only result of the incisions is that the processes of repair follow, wnaccompanied by any marks of in-— flammation. In the absence, therefore, of infection, the processes of repair can go on without producing any painful sensations whatever. 4110. Mrs. Cook, in answer to Question 1801, made the following statement :—“I wish now to refer to Mr. Byrne’s statement made on the first day of this Commission, that the antiseptic treatment of wounds is for the minimising of the likelihood of pain. This is a misleading statement. The antiseptic treatment does not. in any way lessen the pain of a wound. “Nor is that the object with which it is used. The object of it is to prevent the wound from being poisoned by septic matter. The idea of the antiseptic treatment preventing pain has never been brought forward with regard to human beings. I will point io the well- known instance of the King’s operation, when Sir Frederick Treves treated the wound antiseptically, and the papers daily stated that he suffered greatly from the wound, on the authority of his medical attendants.” Is there any truth at all in that state- ment?—The example has nothing, of course, to do with the statement. The fact that the aseptic treat- ment of wounds has abolished pain can be demon- strated simply by taking a walk round the surgical wards, and asking each patient that one comes across who has had an incision of the healthy tissues what pain he has had. Surgical wards in our hospitals are merry places now because the patients are well. All of them have had some anatomical lesion, but the greater number of them are well, and joking and laughing. There is no question of pain at all in our wards, and that furnishes the best possible proof that asepsis has abolished pain. The reason why it has abolished pain is because it has abolished that more serious condition of infection which prevented the heal- ing of wounds, and gave rise to pyeemia and septice- mia, and ended often in a huge epidemic throughout the hospital. The case that Mrs. Cook cites has nothing to do with asepsis; it was a case in which a septic abscess was opened, the case was septic from the very beginning, and it was no good really applying antiseptics in such a case at all, because the wound was septic, and being a septic wound it was naturally painful ; it is those cases which are painful, and it is those cases which are painful in the wards. But the result of surgical interference in such cases is, by relieving the tension, to diminish the pain to a minimum. 4111. There is another statement that Mrs. Cook made in answer to Question 1800, which I should like to point out to you. With regard to Dr. Thompson’s experiments in which curare was given, she said: “So that under the influence of this drug, | which takes away the powers of motion and _ in- tensifies the capacity for sensation,” etc. Is there any truth in that statement? Have we the faintest reason to suppose that curare intensifies the capacity for sensation ?—There is absolutely no evidence to support such a statement; the. evidence that we have, which I have already said is incomplete, is in the opposite direction, namely, that it would diminish the amount of pain, even if it does not abso- lutely abolish it. There is no physiological evidence that it intensifies the sensory impressions. 4112. This question of the action of curare has © largely come before the public in consequence of Claude Bernard’s statement, has it not? Do you know any- — thing about what Claude Bernard stated ?—I have seen it, but I do not remember it. 4113. Was there not a case of a human being that he quoted ?—I think there was, bui I have not got it in my mind. There have been cases since. : 4114. Professor Cushny can, perhaps, tell us about that ?—He can tell you more about it than I could.