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