Seymour M. Farber

Diagnosis of bronchogenic carcinoma by cytologic methods.

Attention has been focused recently upon the application of cytologic technics to the diagnosis of primary carcinoma of the lung. Experience with 100 cases of proved bronchogenic carcinoma has indicated that this technic has diagnostic value. The need for additional diagnostic aids in this disease has been emphasized in reported series (1, 2, 3, 4, 5) in which as high as 50 per cent of the cases were not recognized prior to autopsy. As early as 1887 Hampeln was able to diagnose carcinoma of the lung by examination of unstained microscopic particles of expectorated malignant tissue. Other early workers also reported the diagnosis of cancer of the lung by finding bizarre cells in sputum examined by such simple methods. More recent investigators have blocked and sectioned sputum, using ordinary histologic technics, and some have reported good results (6, 7). The development of wet-film technics has simplified the cytologic study of sputum and bronchial secretions and has led to more widespread use of this di...

Clinical evaluation of enzymatic therapy in diseases of the chest.

Abstract The initial enthusiasm with which enzyme therapy was greeted must now be tempered with caution. Although excellent results have been obtained with application of various enzymes in diseases of the chest, toxic manifestations both immediate and delayed have become numerous enough to give us pause in the routine use of these agents. The main problems to be resolved in enzyme therapy appear to be the following: 1.1. Enzymes used clinically at present are derived from non-human sources and are applied to sites in which such substances would not normally occur. They may give rise to antibody formation with occasional marked hypersensitivity causing severe local and systemic disturbances. 2.2. The enzymes themselves or the products of lysis produce local and systemic reactions of varying severity in almost all patients, depending upon dosage and route of administration. 3.3. Late toxic effects upon epithelium have been seen in the tracheobronchial tree. 4.4. The dissolution of fibrin plugging a bronchopleural fistula or a vessel gives rise not infrequently to hydropneumothorax or severe hemorrhage. Prediction of success or complication in the therapeutic application of enzymes is not now possible. Serious complications may occur early and it is necessary carefully to calculate the risks when enzyme therapy is proposed. This is not to suggest that enzyme therapy should only rarely be employed, but to emphasize the powerful nature of these agents and the dangers in their indiscriminate use.

Cancer of the respiratory system

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WHY NATIONAL CONCERN FOR BIOMEDICAL COMMUNICATION

To deny the importance of biomedical communication at a gathering such as this would be tantamount to contesting the primacy of virtue over vice. In fact, I agree that biomedical communication is essential to the health sciences, that it ought to be improved, and that there is good reason for concern over present inadequate dissemination of medical information. But I believe that our concern should include the type of information we communicate, as well as our methods of communication. My point is that “hard” technical data is a necessary but insufficient prerequisite to achieving and maintaining the highest possible standard of medical practice. There is also a need for national concern about biomedical communication in a broader and indispensable sense which is seriously lacking today. However, before this other aspect of health information is examined, I would like to discuss some features of the communication problem as it is ordinarily considered.

The rational approach in the use of bronchodilators in chronic respiratory disease.

Excerpt Pharmacologic bronchodilators have been used perhaps as long as any known medicinal agent. The use of ephedrine (ma hwang) is shrouded in the mists of Chinese antiquity. The burning of stra...