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Organotherapeutic extracts. Dried brain etc.

Organotherapeutic Extracts.—The use of the extracts of various organs as medicinal agents is one of the oldest known therapeutic measures. Thus, Pliny mentions the use of the brains of animals in the treatment of jaundice, and it is probable that this drug was used also by the ancient Egyptians. The modern use of organic extracts may be dated from the investigations of Brown-Sequard. (A. de P., 1889, p. 51.) Since this time extracts of nearly every portion of the body have been tested therapeutically. From many of these extracts there is no reason to expect any beneficial influence in diseased conditions. On the other hand, it is impossible to deny that many of the glandular organs of the body deliver their secretions directly into the blood stream, and that these secretions are essential for the maintenance of health and it is a priori not unreasonable to expect that the artificial administration of these secretions will have a beneficial influence in certain diseased conditions. It is among the last group of drugs that opotherapy finds a justification for its existence. Three of these organs of internal secretion have achieved so fixed a place in medicine as to have received official recognition, namely, the hypophysis, the suprarenal capsule, and the thyroid-gland. Although the pancreas probably also delivers an internal secretion, the pancreatin of the Pharmacopoeia represents an external and not an internal secretion of the pancreatic gland. There are some which have firmly established their claims, although not yet included in the U. S. P., but the great mass of them are still in the experimental stage.

Cerebrin. Cerebrum Siccum.—The dried brain substance has been used by Babes and others (K. T. W., 1900) in the treatment of neurasthenia, insanity and epilepsy. The treatment, however, has no scientific foundation. Wassermann (B. K. W., 1898, p. 4) has shown that an emulsion of the brain is capable of neutralizing the tetanus toxin. It has subsequently been shown also that this holds true for strychnine and morphine. On this evidence an emulsion of the dried brain substance has been used in the treatment of tetanus and rabies. (Kowalski, K. T. W., 1900, No. 5.) The dose of the dried brain substance is 30 to 60 grains (2-4 Gm.).

Bronchial Gland. Glandula Bronchialis Siccum. —The dried bronchial gland has been used in the treatment of tuberculosis and chronic bronchitis, but with no very encouraging results. The dose is 1 to 3 grains (0.06-0.18 Gm.).

Ciliary Body. Corpus Ciliarae.—The extract of the ciliary body, as well as the vitreous body has been used in sympathetic ophthalmia by Dor and by Wecker. (Annals d'Oculistique, August, 1902.) Oculin is a name applied to a glycerin extract of the ciliary body and vitreous humor.

Kidneys. Renes Siccum.—There is considerable evidence that the kidneys supply an internal secretion, but that failure of this internal secretion is the cause of uremia, as claimed by some, has certainly not been established. Although a number of authors have claimed beneficial results from the administration of the kidney substance in nephritis and uremia, it is probable that the treatment is useless. The dose recommended is from four to fifteen grains (0.26-1.0 Gm.) several times daily. Nephritin is a proprietary extract of this class.

Lungs. Pulmones Sicci.—The dried substance of the lung has been used by Brunei (Press. Med., 1898, p. 22) in tuberculosis, emphysema, and asthma. The dose is seventy-five grains (5 Gm.) a day.

Liver. Hepar Siccum.—Gilbert and Karno (S. M., 1897, p. 184) believe that there is some substance in the liver which leads to a retention of the glycogen out of the blood in the liver, and that the administration of this substance is of benefit in the treatment of diabetes. Gyr asserts that the extract of the liver is also useful in hepatic cirrhosis (R. M. S. R., June 20, 1908), and in hemeralopia by Roncagliolo (Med. Klin; 1905, p. 909). The dose of the dried liver is one-half to one ounce (15-31 Gm.) per day.

Mammary Gland. Mammae Siccatae.—On the theory that there is some relation between the uterus and the mammary gland, the latter has been used by Shober (Phila. M. J., Nov., 1899) and others, in the treatment of menorrhagia, fibromata, dysmenorrhea, etc. The dose of the dried gland is five to ten grains (0.32-0.65 Gm.) three times a day.

Ovaries.—That the ovaries deliver an internal secretion which if not essential to life, certainly modifies in some way metabolism, is almost universally accepted. One of the strongest proofs of this is seen in the symptoms which occur at the menopause or after double oophorectomy. The corpus luteum, according to Ott and Scott (Proc. of the Soc. of Exper. Biol. and Med., 1910, viii, p. 49), has a marked stimulating effect upon the mammary gland, but the ovarian substance when deprived of this was without such action. There is strong clinical evidence that the administration of the ovarian substance will at least temporarily relieve the symptoms seen at the menopause, whether the latter is natural or artificial. Richter (D. M. W., 1899) has found that there is a marked increase in the fatty metabolism under the feeding of the ovarian substance. These investigations have been confirmed by Thumim. (Ther. Geg; 1900, p. 451.)

The ovarian substance has also been used in the treatment of neurasthenia by Vidal (Press. Med., 1900, p. 173) as well as in a host of other diseases in which there was much less likelihood of benefit following its administration. (For review of the literature, see Offergeld, D. M. W., 1911, p. 1172.)

The corpus luteum has been used for various disturbances of pregnancy on the ground that these were due to the natural intermission in this function. The dried ovarian substance is marketed in various strengths. Ovariin represents eight times its weight in fresh bovine ovarian substance; the dose is three to six grains (0.2-0.4 Gm.). Ovaraden represents two parts of the gland and may be given in doses of fifteen to thirty grains (1-2 Gm.). Other proprietary preparations of the ovarian substance are glandnovin, ovadin, ovarial, ovarigen, oophorin, ovaron, and lutein. The dried corpora lutea is given in doses of one to five grains (0.065-0.32 Gm.) two or three times a day.

Parotid Gland. Parotis Siccum. Glandula Parotidis.—Believing that there is some connection between the parotid and the sexual organs, Bell (Ther. Woch., 1896, p. 659) has employed the parotid gland in the treatment of dysmenorrhea, ovarian neuralgias, and other disorders of the pelvic organs. The dried substance is usually administered in tablet form in doses of from one to three grains (0.065-0.2 Gm.) three times a day.

Parathyroids. Glandula Parathyroidea.—These are four small bodies growing near the lateral lobes of the thyroid gland. Because of their anatomical proximity it was at one time believed that their function in the body was similar to that of the thyroid body, but it is now known that these two organs are in no way physiologically connected. The parathyroid bodies, however, are among those organs whose removal is fatal. The most prominent symptom caused by parathyroidectomy are tetanic convulsions. Ott and Scott (Amer. Med., 1910) have found that the parathyroid extract has a powerful diuretic influence. The dried parathyroid gland has been used in the treatment of tetany. (Loewenthal, Med. Klin., 1907, p. 1012.) It has also been used by Meyer (Ther. Geg., 1913, 354) and Berkley (N. Y. M. J., Nov. 23, 1907) in treatment of paralysis agitans. The dose is one-tenth of a grain (0.006 Gm.) two or three times a day.

Prostate. Glandula Prostatae Siccae.—This substance has been used, without any reasonable justification, in the treatment of prostatic enlargement, and in prostatorrhea. The dose of the dried substance is two grains (0.125 Gm.).

Spleen. Lien Siccus.—It can hardly be considered definitely established that the spleen furnishes any internal secretion. According to Danilewsky and Salensky (A. G. P., 1895, p. 264), however, the subcutaneous injection of the splenic extract produces an increase in the percentage of hemoglobin, and in the number of red blood cells. It is also asserted that there is an increase in the number of the white corpuscles. It is possible that these effects are not due to any substance peculiar to the spleen, but to the nucleinic acid which it contains. Accordingly, the splenic extract has been used in the treatment of anemias, with more or less beneficial results. Carpenter (D. M. Ztg., 1907, p. 571) asserts that it has a specific action in malaria. H. C. Wood (A. J, M. S., 1897, p. 511) has found it useful in Graves's disease. It has also been recommended in various forms of insanity. One of the difficulties in the use of this drug is to obtain a preparation which is active and yet will be borne by the stomach. The dried powder is given in doses of four to fifteen grains (0.26-1 Gm.) three times a day. It is doubtful, however, how far it entirely represents the drug. Under the name of eurythrol, an aqueous extract has been marketed. The dose of this is one to two teaspoonfuls, given generally in soup. Lienaden and opolieninum are proprietary preparations of spleen.

Testicles. Testes Sicci.—The basis of the famous elixir of Brown-Sequard, Liquor spermaticus, was the fluid contained in the testicles. The persistent use of the various imitations and modifications of the Brown-Sequard Elixir would argue that it must possess some therapeutic virtue. It is claimed by those who use it that it has a powerful tonic effect, not merely improving the strength, but also exercising a beneficial influence upon the metabolism, so as to lead to a permanent augmentation of power. It has been recommended for neurasthenia, diabetes, locomotor ataxia, arteriosclerosis, and a large number of other chronic complaints.

The dried testicular substance is given in doses of from ten to thirty grains (0.65-2 Gm.), but it is generally recommended as a liquid preparation, and that it should be given hypodermically. Among the preparations which contain testicular fluid as their important ingredient are the Siccus e Testibus Paratus, orchidin, Hawley lymph, testaden, testidin and teston.

Mesentery Gland. Coeliacin.—The dried mesentery gland has been used by Schwerdt (M. M. W.. 1907, p. 1230) in the treatment of scleroderma. The dose he employed was five grains (0.3 Gm.) twice a day.

Thymus Gland. Glandula Thymi Sicca.—This body, which is the ordinary sweet-bread, is found only in young animals, disappearing as adult life comes on. Physiologists are not agreed as to its exact importance or function. It appears to have some connection with the growth of bone and also of the formation of the white corpuscles of the blood. It has been used in medicine chiefly for two purposes, namely, in the treatment of exophthalmic goiter, and for the purpose of stimulating bony growth in rickets and ununited fracture. It should be remarked that thymus contains a larger percentage of nuclein than any common food stuffs, and for this reason its use is generally forbidden to gouty patients. The dose of the fresh gland is from one drachm to half an ounce (2-15 Gm.); of the dried gland five to forty-five grains (0.32-3 Gm.).

Bone Marrow. Medulla Ossium.—This has been used by Gullan (Lancet, 1907, p. 520), and others, in the treatment of pernicious anemia. Gullan administered it by spreading the fresh red bone marrow on bread, which is taken at meal times. It is very prone to produce nausea. The dose of the fresh marrow is one to three ounces (31-93 Gm.); of the dried marrow two to five drachms. (7.7-20 Gm.). Opo-osslin and ossagen are proprietary preparations made from bone-marrow.

Spermin.—A salt solution of the hydrochloride of the amine spermin (C5H14N2), a normal constituent of the spermatic fluid. It is used as a nerve tonic and stimulant in all diseases due to auto-intoxication, as typhus, syphilis, etc. Dose, subcutaneously, sixteen minims (1 mil) of a two per cent. solution; by mouth, ten to thirty drops (0.6-1.8 mils) of a four per cent. solution.

The Dispensatory of the United States of America, 1918, was edited by Joseph P. Remington, Horatio C. Wood and others.

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