GENERAL DIRECTIONS 197
over,
it must be understood distinctly, that if “test cases” are to be treated, after
the lines of Messrs. Ball and Thomas and Dr. W. S. Bainbridge, certain other
scientific stipulations must be made, and in scientific fashion “the test” must
be carried out under rules of procedure agreed upon between the testing surgeon
and the scientific investigator. In other words, all apertures for the creeping
in of “errors of experiment” must be closed up. Above all, cases such as
post-operative recurrent ones, in which any other treatment had been employed
previously, cannot be used and cited as failures in any test claiming to be
scientific.
1. From Captain Lambelle’s results, published
and unpublished, and from the outcome of the Uppingham case, the treatment
appears to be applicable to inoperable, recurrent, and primary cases; but in
taking up treatment the physician is urged to bear in mind all along the size
and extent of the tumour and the previous history in fixing upon strengths and
doses. On occasion much larger doses might probably be injected with safety,
provided that for every increase of trypsin an adequate amount of amylopsin be
injected at the same time; or under the system of Roberts units advocated, for
every tryptic unit let there be at least two amylolytic ones.
2. The injections should be freshly made,
and whenever possible not many days old. All boxes should bear the date of
manufacture.
3. On no account may the injections be made up
from commerical “ trypsin in powder” or similar things.
Great
stress must be laid upon both of these points. Obviously injections containing
peptones are unfit for use, though in some instances the treatment has been
condemned after the employment of such. A special reason for the use of
freshly-made-up injections lies in