GENERAL DIRECTIONS 189
obtainable some years ago. When injections for use in cancer were first on sale, none of the makers did, or could, furnish any general directions as to how they should be employed. Many were the letters received by the writer, especially from French and Italian physicians and surgeons, asking for some directions as to the procedure to be adopted. These requests led to the first “ general directions” from my pen. These latter were constantly being altered in accordance with the reports received and the knowledge gained. Even in their final form, as printed for my convenience in 1907, they professed to lay down no strict course applicable to all cases. It was written: “The question of proper dosage is not yet decided finally, and it will probably be found to vary with different cancers.” Many of his friends and correspondents will, if need be, confirm the statement that all along the writer’s chief concern has been to impress upon physicians and chemists the urgent necessity of seeing that every dose of trypsin was accompanied by an adequate amount of amylopsin. The one injection was termed, unfortunately, injectio trypsini by the makers, but those with which I was in any way concerned always contained some amylopsin, a quantity which I could never get made large enough for the requirements. As will be seen, this has now been brought about in another way.
Even now it is not for me to lay down any fixed limit of size of tumour, or of time for the previous growth of the tumour, beyond which success cannot be hoped for but it must be insisted, and emphasis laid upon the point, that no treatment can be considered adequate, unless it be such as will more than overcome, more than negative, the antitryptic (toxic) properties of the cancer ferment, malignin. To find in very bad cases, as some