By CHARLES H. DUNCAN, M.D.
IT is the object of this article to call the attention of physicians to a remedy that will usually cure puerperal sepsis. It is an immediate remedy, and, what is more to the point, it is effective and cheap. In addition, it is capable of wholesale application.
The extension of the principle that underlies the cures made by the use of this remedy takes in the whole range of curative medicine and much that now lies entirely beyond its borders. The discovery of this remedy marks a step forward in the development of bacterial therapy. What is called autogenous vaccine, strictly speaking, is not autogenous, but “test-tube ogenous.” For culture media, on which all vaccines grow, alter and change the bacteria morphologically, biologically and therapeutically.
There are no therapeutic reasons why bacteria used as a curative agent should be grown on artificial media, and there are many good reasons why they should not be so grown. The therapeutic qualities of micro-organisms, composing all vaccines, are also altered by the heat and chemical preservatives necessary in their preparation.
The original, unchanged micro-organism-complex and the toxic results of its activity on the tissues of the living body are most therapeutically effective when properly and promptly administered to the patient from whom they were taken. This is beautifully illustrated by the well-known fact pointed out by the winter twenty-two years ago, namely, that the dog licks and cures its injured paw. This is a matter of common observation and daily demonstration. This is the basic fact on which we built our newly discovered therapy. The dogs wounded paw heals by a biological reaction, caused by transferring a few of each variety of the unchanged infective bacteria complex and its associated toxic products of germ activity from the wound into its mouth.
The micro-organisms and their toxins taken into the dogs mouth are not altered or changed in any way. The antigen of each is present and unchanged. They are taken as Nature intended they should be, and, as a result, they quickly cure the infection of the paw or other part of the body within reach of the tongue. Wounds that are thus lapped heal without the practice of asepsis, or the use of antiseptics, sterile gauze or skilled attendants.
The Creator intended every wound, in both man and animal, to be infected, but He did not intend the infection should become severe or that the patient should become severely ill, or that the patient should die from this infection. For He placed within each wound the remedy He prescribed for its cure. We have never clearly understood this biological principle. The result is that millions upon millions of human patients suffer and die annually in all parts of the world from pus infection of some kind, when the remedy prescribed by Nature to cure each infection lies within the infected area itself.
The dog, by taking the parent micro-organism complex into its mouth, fresh from the wound, by the inherent power of its living tissue, automatically develops their antibody complex or resisting substances. These, circulating in the bloodstream, reach the infected area, where they destroy each variety of the infecting micro-organisms remaining in the parts and antidote their toxins.
It is this biological reaction that enables the dog to cure its infected foot by lapping it. Its wounds do not heal by the mechanical cleansing action of the tongue, as is commonly held, nor does the antiseptic quality of the saliva have, as far as is known, any effect on wound healing.
This therapeutic principle is clarified and comes with more force and we gain a better understanding of the subject if we consider the additional fact that animal mothers seldom or never die from infection following the birth of their young. We believe they always are infected. For pus-producing germs are upon everything they touch. Yet animals seldom or never die from this uncomplicated infection. This is an indisputable fact.
During twenty-two years of continuous study of this therapeutic principle, the writer discovered that the principle of immunisation by way of the mouth that animal mothers employ in curing themselves may be safely transferred to human mothers. This will cure uncomplicated cases of puerperal sepsis in human mothers with as much regularity and certainty as it cures incipient infection in the animal.
This is of undeniable interest and of international importance. Every nation is asking to-day: “What can be done to reduce the frightful loss of mothers who die from infection at childbirth?” This question is now answered. It is surprising and deeply humiliating to be told that severe puerperal infection is a human disease, for animal mothers, though always infected at the birth of their young, seldom, or never, allow their uncomplicated incipient infections to progress to the point of septicemia or blood-poisoning, and never die from it.
They invariably cure uncomplicated infectious that follow the birth of their young. The most ignorant farmer knows this is so. He never expects his sheep, pigs, cows and horses to die and he seldom, if ever, is disappointed. The only exception to this rule is a disease known as “Septic Abortion,” that sporadically breaks out in cattle. There is no doubt in the writers mind that this infection may also be conquered by the “filtration method” that will be explained in the later paragraphs of this article.
The writer, as operating surgeon of the Volunteer Hospital in New York City, from 1905 to 1916, has had unlimited opportunity of studying, demonstrating and perfecting this line of treatment. In his endeavours to improve the technique and discover, if possible, a more acceptable method of treatment than giving pus by the mouth, he filtered a watery dilution of the exudate from a patients body through a germ-proof filter and injected, with a needle, the transparent, colourless, odourless and tasteless filtrate back into the patient from whom it was taken, and found it is as curative as the method of treatment by mouth employed by animals. He found in addition that it is much quicker in its action. The technique of the application of this principle will be given in the case reports at the end of this article.
When it was found that pyogenic infection may be quickly and easily cured in practically any stage, by injecting the filtrate of a watery dilution of the patients own pathological exudate with a needle, the thought occurred: “Why should not the filtrate act in a curative manner in all other infectious diseases, such as coughs, colds, pneumonia, mastoiditis, measles, abscesses, gynecological infections, whooping cough, etc.?” Because all infectious diseases have a pathological exudate, in the form of pus, mucus etc., which contains the unmodified infecting germs or bacteria and the products of their activity from which the patient suffers.
This method of treatment is called in all American standard medical dictionaries, “The Duncan Method of Treatment.” It was found that this principle of immunising the patient to his own unmodified toxin complex, that is in the filtrate, takes in the whole range of curative medicine, and much that now lies entirely beyond its borders. Disease is the manifestation of toxic substances within the body. Immunise the patient to the unmodified toxin complex from which he suffers and the symptoms disappear.
It is apparent that our present methods of treating puerperal sepsis are not sufficiently far-reading, or are basically at fault and that something else in addition is needed to control the situation. For eight thousand mothers now die annually in the United States and five thousand in Great Britain from this condition. This missing link is what the Duncan Method of Treatment supplies. When it is once pointed out how simple and efficacious this remedy is and how easily applied, “It is a Wonder,” in the words of Professor Cobet, of Breslau University, “that it was not discovered long ago”.
Let us return briefly to the present methods of treating puerperal sepsis. Asepsis is ideal in the treatment of surgical wounds, uncomplicated with bacterial infection. Since this is so, aseptic technique has been considered ideal in treating infection at childbirth. It is ideal only in so far as it keeps out additional or subsequent infection from without, for in treating obstetrical patients aseptically we do not take sufficiently into consideration the fact that some infecting agents are often present that lie beyond the reach of local antiseptics.
It is perfectly clear that in the presence of a deep-seated pelvic infection, something in addition to the application of anti-septics is required if the best results are to be obtained. This addition is supplied by the Duncan Method of Treatment. Theoretically, when employing this treatment, it makes little difference whether additional infective micro-organisms creep into the wound or not, for practically each pyogenic germ that may cause, or complicate, the infection works out its own destruction. Practically we should employ asepsis, especially in closed wounds.
All civilised countries have laws compelling physicians to cleanse the eyes of all new-born babies with some salt of silver, in order to prevent blindness in the child. This law assumes that infection of the mother, is so prevalent that the best interests of the child are conserved by taking this precaution.
We have never had adequate means of conserving the life of mothers from infection at childbirth, although it is recognised that she is frequently previously infected in some form or other, as from gonorrhea, former septic abortions, etc.
There is no doubt in the writers mind that when the profession thoroughly understands the Duncan Method of Treatment laws will also be passed compelling physicians to employ this method of treatment, both as prophylactic and a cure from puerperal infection. For this treatment will in a large degrees conquer this infection.
The United States has the largest maternal mortality rate of any civilised nation on the globe. As stated, eight thousand homes are broken up every year by the loss of mothers who die from uncomplicated puerperal infections. In view of what the Duncan Method of Treatment offers mothers at this critical time of their lives, we now see that the loss of nearly all those mothers is needless.
It is murder to allow mothers to die when there is a means at hand that will save them. This crime becomes more heinous when we realise that each mother has the remedy designed by Nature to cure her infection within her own body and that she needs only be told of this fact in order to cure herself.
Nor should it be forgotten that two lives are often at stake. About a year ago the Rockefeller Foundation in New York City gave a large sum of money to the Queen Charlotte Hospital in London to investigate and find out, if possible, if something could be done or discovered that will reduce the worlds frightful maternal mortality rate. I trust that a copy of this article may be brought to their attention, and that it may be useful in their exhaustive studies of this important subject.
In the two case reports appended we have sought to give the technique that has been employed successfully by hundreds of physicians in all parts of the world. While it is impossible to give set rules that will fit all cases, so, in the cases given we have endeavoured to give the average dose that has been found effective.
Case I. Patient 19, primipara, was brought into the hospital, September 28th, 1912, eight days after delivery, suffering with puerperal infection. The infecting micro-organism was the streptococcus long chain. The white blood count was 18,000; temperature 104 F.; pulse 120. The prognosis was grave. The infection had extended to the peritoneum. The whole abdomen was tender and distended. Tongue white, no appetite.
Treatment. Four drops of the muco-bloody discharge from her napkin was placed in 4 oz. of tap water. She was given one teaspoonful of this every ten minutes for ten doses. Then to stop. Then a teaspoonful of the mixture three times a day for the ensuing six days. She went to sleep after the fourth dose and slept for eight hours. When she awoke her temperature was 101 F., pulse 100, and she was hungry.
No other treatment was given her for twenty-four hours, when she was given a teaspoonful of the same mixture three times a day as ordered. I omitted to state she was given an enema when admitted to the hospital. She made an uneventful recovery. This has been duplicated many times by hundreds of physicians in all parts of the world, and so far I have heard of no failures.
Case II. Patient 28, mother of two, was brought into the hospital January 10th, 1914, six days after delivery, suffering from puerperal infection. The infecting microorganism was diagnosed microscopically as a mixed staphylococcus and streptococcus. White blood count 20,000; temperature 96 F., pulse, 160; respirations 10. She was in a state bordering on coma, semi-conscious. Cold, clammy sweat covered the whole body. The discharge was foul smelling. It was difficult at this time to elicit other symptoms. Four drops of pus from her napkin was placed in 1 oz. of distilled water. This was thoroughly shaken up for ten minutes. Distilled water is the all-solvent, and the toxins from these micro-organisms are extremely soluble.
This was then passed through a germ proof (Berkfeld) filter and 1 cc. of the filtrate together with 4cc. of a physiological normal salt solution was injected subcutaneously over the biceps muscle. Within ten minutes the cold sweat was replaced by a warm glow over the entire body, her respiration had improved and she sank into a deep sleep, in which she remained for ten hours. She awoke not knowing where she was, but refreshed. Temperature was 100F., pulse 100, respiration 20, and she was hungry. On the following day she was so much improved that another treatment was not given, but forty-eight hours after the first injection she received another similar treatment. At the end of three days she was out of danger and received but two other treatments at forty- eight hour intervals.
This is the method of choice and is employed widely in the United States for these desperate conditions.