THE 
PHILADELPHIA POLYCLINIC. 
VOL. 11. 
NOVEMBER, 1893. 
No. 11. 
THE THERAPEUTIC PROPERTIED OF ANIMAL 
EXTRACTS.1 
Solomon Solis-Cohen, 'A. M., M. D., 
PROFESSOR OF CLINICAL MEDICINE AND APPLIED THERAPEUTICS IN THE 
PHILADELPHIA POLYCLINIC, ONE OF THE PHYSICIANS TO THE 
PHILADELPHIA HOSPITAL, ETC. 
Gentlemen:—In connection with the treatment by hypo- 
dermatic injections of an extract of the pancreas, of a case 
of diabetes in the wards, and in connection with the treat- 
ment by dessicated thyroid gland of some cases of circula- 
tory disorder in patients attending the dispensary, it has 
been suggested that I should discuss with you the general 
subject of the use of animal extracts in the treatment of 
disease. This, as you are aware, is by no means a new 
therapeutic method ; it descends from the fathers of medi- 
cine ; by whom, I mean not Hippocrates and Galen, but 
the shamans, the wizards, and the obi-men of savage 
tribes. 
Western medicine has progressed beyond the stage of 
witchcraft, but even to-day, in China and other eastern 
lands, the viscera of animals and the bodies of reptiles are 
favorite medicinal preparations. You may be familiar with 
one of Sir Edwin Arnold’s poems of Japan, which turns 
upon the necessity of obtaining a fox’s liver to cure a royal 
princess. In reward for kindness once shown by this lady 
to the foxes, the fox-wife brings her husband’s liver in a 
basket, and places it at the foot of the princess’s couch. 
JLecture delivered at the Philadelphia Polyclini 310 
SOLIS-COHEN, 
In our own times, the practice of seeking in the glands 
and viscera of animals for preparations of medicinal virtue 
has received a great impulse, almost to be termed a revival; 
first, through the experience of Brown-Sequard with tes- 
ticular juice, then through that of British physicians with 
preparations of the thyroid gland, its greatest notoriety, 
however, being owing to the very recent publications of 
Ex-Surgeon-General Hammond. 
In order that you may be able to follow the subject intel- 
ligently, let me, before going further, state the results; 
for which, afterward, I will give what appear to me to be the 
reasons. 
Except in the hands of Brown-Sequard and his immediate 
colleagues, the injection of preparations of the testicles of 
animals has proved of very limited and uncertain therapeu- 
tic usefulness. 
There is no testimony of wdiich I am aware, other than 
that of Dr. Hammond in favor of the therapeutic virtue of 
that observer’s “ cerebrine ” and “ cardine.” 
Great therapeutic power has been demonstrated for prep- 
arations of the thyroid gland in the treatment of a certain 
group of disorders associated with diseases of the thyroid 
gland ; namely, myxedema, cretinism and cachexia strumi- 
priva; and more recently it has been said to be of use in the 
treatment of scaly diseases of the skin. It has proved of 
limited service in my hands, in a few cases, in the temporary 
relief of symptoms in exophthalmic-goiter and other forms 
of vasomotor ataxia, in diabetes mellitus, and in one case 
of akromegalia. 
Preparations of the pancreas, aside from their well known 
benefit as digestive agents, have in the hands of Dr. Neville 
Wood, of Dr. Mansell, of Dr. Hector Mackenzie, and of 
others, including myself, proved useful, but not curative, in 
the treatment of certain cases of diabetes mellitus. 
Preparations of the thymus gland have, in the hands of Dr. 
Charles Macalester of Liverpool, proved of great service in 
the treatment of pseudo-hypertrophic paralysis and general 
lymphadenoma, both of these being, as you will observe, THERAPEUTIC PROPERTIES OF ANIMAL EXTRACTS. 
311 
diseases of nutrition; diseases in which errors of metabo- 
lism are prominent features. 
Preparations of nerve-tissue have been used by Gibier and 
others with varying results in epilepsy, in paralysis agitans, 
and in functional nervous disorders. 
Here is the record of experience. Let us see what theory 
would indicate and compare our theoretic conclusions with 
these records. 
Between such organs as, for example, the brain and the 
thyroid gland, there are many and great differences. One 
of these differences is all-important for the present discus- 
sion. The thyroid gland is a secretory organ; the brain is 
not. Without entering into a discussion of the exact 
nature of the process, concerning which the evidence is not 
clear, it is sufficient to know that clinical and experimental 
observations are at one in demonstrating that the thyroid 
gland manufactures some substance, which by its function 
in the economy, prevents the occurrence of the symptom- 
complexus termed myxedema or cachexia strumipriva; the 
former name being applied when the gland atrophies 
through disease, the latter when it has been removed by 
surgery. 
Such being the case, it is natural to expect that if in cases 
in which defect or absence of the secretory functions of the 
thyroid gland has resulted in the development of these 
symptoms, we artificially supply the lacking secretion, the 
symptoms would disappear. The facts, as already stated, 
justify this expectation. 
At first, the implantation of a thyroid gland in the abdo- 
men was tried and proved successful with men and with 
animals. Later, Dr. Murray of Newcastle, England, injec- 
ted subcutaneously preparations obtained by macerating the 
finely minced thyroid with glycerin, and still later, Hector 
Mackenzie and others showed that the administration of thy- 
roid extract, of raw thyroid, and of dessicated thyroid by 
the mouth was equally efficacious. 
The principle is exactly the same as that upon which we 
administer pepsin or pancreatin to replace the natural pep- 312 
SOLIS-COHEN, 
sin or pancreatin in digestive disorders; the body failing 
to furnish a certain substance which is necessary to the 
proper nutrition of all the organs, we supply that lack by 
administering a similar substance obtained from animals. 
The mode of action, it is true, is somewhat different. 
The digestive ferments act locally in the stomach, that is 
outside the physiological interior of the body and upon 
foreign materials—food-stuffs. The thyroid preparations act 
within the blood or lymph after absorption, or if locally, 
upon the diseased tissues. The function of the gastric and 
pancreatic secretions in digestion is to prepare materials for 
nutrition ; the function of the thyroid secretion is, probably, 
to destroy or antagonize certain products of function that 
otherwise act as toxines. In addition it prevents exaggerated 
growths of certain tissues. In a word, its function, as I 
have previously expressed it, is in truth “ chemiotactic,” 
that is inhibiting or regulatory in regard to the metabolic 
chemistry. 
It will be observed, moreover, that whatever it may be 
that is accomplished by the administration of thyroid 
extract, it is not the cure of disease of the thyroid gland. 
No one, surely, expects to cure disease of the peptic glands 
by giving pepsin, or disease of the pancreas by giving pan- 
creatin. It is the complex disorder resulting from the 
absence of thyroid secretion which is relieved in the one 
instance, just as it is the disorder caused by the absence of 
joeptic or pancreatic secretion which is relieved in the other 
instances. In either instance there is no cure, for unless 
the administration of the thyroid preparation is kept up 
indefinitely, the symptoms due to the absence of thyroid 
secretion return just as the symptoms due to the absence of 
pepsin or pancreatin return when the administration of 
these drugs is stopped. Cure can only be obtained by 
measures which will secure natural reproduction of the 
missing secretions. So far as the thyroid gland is concerned 
we know, as yet, of no measure competent to effect this end. 
Now, let us look at the other side of this question of ani- 
mal extracts. The brain, so far as we know, secretes THERAPEUTIC PROPERTIES OF ANIMAL EXTRACTS. 
313 
nothing physical. So far as we know there is no symptom or 
symptom-corn plexus which can be attributed to defect in 
any supposed secretory function of the brain. Conse- 
quently, there is nothing in the whole nosology which on 
theoretic grounds, the administration of brain extract 
could be expected to remedy. Similarly, the heart so far 
as wre know, secretes nothing and there is no symptom or 
symptom-complexus which can be attributed to default of 
supposed secretory function on the part of the heart. 
Equally, therefore, there is no ground for the administra- 
tion of heart extract to remedy disorder caused by disease 
of that organ. For, let us remember, the thyroid extract 
does not cure thyroid disease, the thymus extract does not 
cure disease of the thymus, the pancreatic extract does not 
cure disease of the pancreas; and to expect brain extract to 
cure brain disease, or heart extract to cure heart disease, is 
on a par with the science of the Obi-doctor and the practice 
of the lizard-giving Chinamen. 
This, however, does not exhaust the possibilities of the 
subject. Preparations of the tissues and juices of animals 
have a recognized place in the pharmacopeia. Thus, you 
are familiar with cantharidis and perhaps with blatta lap- 
ponica. 
There is no reason, whatsoever, why the toxic and nutri- 
tive properties residing in substances of animal origin 
should not be utilized in medicine just as the toxic and 
nutritive properties residing in substances of vegetable and 
mineral origin are utilized. First, as to toxic properties : I 
say toxic properties, because while ordinarily we restrict the 
term toxic to effects which greatly disturb function or 
jeopardize life, yet, strictly speaking, every disturbance 
however slight, that is set up in the human economy by 
foreign substances, is a toxic effect, and it depends on the 
degree and character of that toxic effect whether the ulti- 
mate result is remedial or otherwise. The effect of atro- 
pin in paralyzing accommodation and causing mydriasis 
is, in suitable cases, therapeutically beneficial, but it is none 
the less the same in kind as the harmful effect that would 314 
SOLIS-COHEN, 
result from an overdose of the same drug. 
There are many substances of animal origin, or that can 
be obtained by chemical manipulations of animal tissue, 
which possess the power of modifying the action of differ- 
ent organs and tissues of the human body; and I repeat, 
there is no reason whatsoever, why the properties of these 
substances should not be availed of in medicine. It needs 
only to be remembered that the particular organs or tissues 
from which such substances may be extracted bear no neces- 
sary relation to the organs affected in the diseases for the 
treatment of which these products may be employed. 
Thus, thyroid extract has a very decided diuretic power, and 
I have employed it with satisfaction, as a diuretic in a case 
of nephritis in a patient with no apparent disease of the 
thyroid gland. 
Brain extract may, perhaps, prove to have beneficial 
action upon the heart or upon the kidneys; kidney extract 
may have a useful influence upon the organs of respiration ; 
lung extract may have an hypnotic power. In other 
words, the true line of experimentation with animal 
extracts is the same as the true line of experimentation with 
drugs of mineral or vegetable origin. Their physiological 
or toxic powers should be studied in the laboratory and 
tested clinically without reference to their source; and only 
after such studies have been carefully made, can conclusions, 
be drawn as to the probable usefulness in medical practice 
of the substances investigated. 
And now, a word as to the nutritive properties of ani- 
mal extracts. It may be that such extracts will afford a 
readily assimilable pabulum in diseases of certain tissues 
and organs, as we know such pabulum is furnished by 
preparations of phosphorus, iron, and other mineral sub- 
stances found in the normal body, and by caffein and other 
vegetable products. Hence the injection of preparations of 
nerve-substance may have a rational basis. Again, it has 
been shown that certain important functions in resisting 
infection and in maintaining nutrition are performed by the 
nuclei of cells, and it may be that all animal extracts will THERAPEUTIC PROPERTIES OF ANIMAL EXTRACTS. 
315 
prove useful by virtue of the chemical constituents of the 
nucleus. This, too, is a proper field for clinical observation 
and laboratory experiment. 
That the action of the thyroid gland in the treatment of 
myxedema is of an entirely different nature from either of 
these processes; that it is neither toxic nor, except in a very 
broad sense, nutritive;—that is, that while it regulates nutri- 
tion and prevents aberration of metabolism it is not directly 
used as a food element—I have already sufficiently explained. 
The action of the preparation of thyroid gland in relieving 
the headache of my case of akromegalia is possibly to be 
explained upon a somewhat different theory. The head- 
ache of akromegalia is due, at least in great part, to enlarge- 
ment of the pituitary body. This enlargement of the pit- 
uitary body is probably supplementary to want of function 
on the part of the thyroid gland, the two being related 
embryologically. The administration of thyroid extract 
in this case may do away with the necessity of enlargement 
on the part of the pituitary body. But in a case in which 
the pituitary had already been enlarged sufficiently to pro- 
duce permanent pressure symptoms, the administration of 
thyroid extract would not be expected to have any very 
decided result. In a mild case, where the process of enlarge- 
ment was but beginning, it might be expected to hold that 
process in check. As to the effect of the thyroid extract in 
mitigating the general symptoms of akromegalia, experience 
is not yet sufficiently great to speak positively. I should 
expect it to act favorably in a recent case, and even in an 
old case to modify the progress of the disease. Of its effect 
in relieving headache in several cases of vasomotor disorder, 
and in one case of diabetes, and of its apparent temporary 
good effect in one case of exophthalmic goiter, I am not yet 
prepared to offer an explanation. The facts are worthy of 
record; beyond that, as yet, I cannot go. The doses used, 
which at all events are not dangerous in patients other than 
myxedematous, were from 10 to 15 grains of a dessicated 
preparation of sheep’s thyroid gland made by Messrs Parke 
Davis & Co., and of which thirty grains represent an aver- 316 
SOLIS-COHEN, 
age gland. This was given once or twice daily, with aro- 
matic powder, in hot beef-tea, or in hot coffee. The fact 
that similar doses could not be borne in myxedema, in 
which affection half a gland once a week seems to be effec- 
tive, would indicate that in myxedema under the influence 
of the thyroid extract the abnormal tissues undergo chemi- 
cal change, throwing into the circulation products that 
would be toxic if in great quantity, and hence must not be 
produced too rapidly for the excretory organs to deal with. 
In cases associated with cardiac lesion, absolute rest during 
treatment is said to be necessary; as two cases in which this 
precaution was neglected have proved fatal. 
The administration of pancreatic extract in diabetes rests 
upon the experiments of Minkowsky, Lepine, and others 
who attribute a glycolytic function to some internal secre- 
tion of the pancreas. They found that when they had 
entirely extirpated the pancreas in certain animals, diabetes 
mellitus ensued ; whereas, if a small portion of the pancreas 
were left, or if a pancreas graft had previously been success- 
fully made beneath the skin of the abdomen, these symp- 
toms either did not occur or were but transient. In this 
connection, we must remember that the mere secretion of 
sugar is but an incident in true diabetes, and as Harley has 
suggested, it is not alone deprivation of glycolytic ferment, 
but also the failure to remove or destroy certain excremen- 
titious products ordinarily dealt with by the pancreas that 
renders the disease fatal. It is difficult, however, to deter- 
mine clinically whether or not a given case of diabetes is of 
pancreatic origin. It is also as yet undetermined how 
much or how far in so-called pancreatic diabetes—that is, 
in cases that have exhibited pancreatic lesion post mortem, 
and in the experiments described—involvement of, or injury 
to the ganglia and nerves of the sympathetic system is 
responsible for the diabetic complexus of symptoms. 
Thus while the administration of preparations of the pan- 
creas by the stomach and hypodermatically is a legitimate 
expedient in any case of diabetes mellitus, and especially in 
cases associated with emaciation, we must not expect too THERAPEUTIC PROPERTIES OF ANIMAL EXTRACTS. 
317 
much from it. 
In the case under observation at this hospital, we began 
with the injection twice daily of twenty minims of a spe- 
cially prepared aseptic glycerin extract of the pancreas 
kindly manufactured for me by Messrs Parke, Davis & Co. ; 
and we increased the dose up to forty minims twice daily. 
No bad local effect, such as digestion of the tissues or 
abscess, as I at first feared might be the case, was produced 
in a preliminary trial upon animals and upon himself, kindly 
made by our former resident physician, Dr. J. C. Knipe; 
and none resulted in our patient. The patient increased in 
weight and comfort; his skin became moister; his thirst 
diminished ; and as less water was ingested less was excre- 
ted ; but we observed no constant or decided effect upon the 
quantity of sugar excreted. 
This, I believe, tallies with the experience of other observ- 
ers. I have a case now under observation in private prac- 
tice, in which improvement seems to have resulted through 
the administration of liquor pancreaticus by the mouth, but 
in this case also, the improvement is in the general condi- 
tion of the patient and not in the excretion of sugar. 
I have had but one experience with the Brown-Sequard 
fluid. Through the courtesy of my colleague, Professor 
Thomas S. K. Morton, I received from one who had received 
it direct from Brown-Sequard’s laboratory a sealed packet of 
this preparation. I used it (strictly according to the direc- 
tions accompanying it, upon a patient at the Philadelphia 
Hospital, to whom the nature of the preparation and of the 
effects expected were explained. The patient was an intelli- 
gent man and welcomed the trial of the substance upon 
himself. The effect of suggestion was certainly not absent 
from the factors in the case. The result of the experiment, 
however, was nil. No improvement whatever resulted, 
although the case was a favorable one; debility without 
serious organic disease in a man of about sixty years of age. 
To sum up, I would repeat my conclusions in the follow- 
ing form; Aside from their nutritive properties as general 
food or as food for special tissues, and aside from such anti- 318 
SOLIS-COHEN, 
septic power as may be due to the chemical constituents of 
cells or nuclei, preparations of animal organs and tissues may 
have, in the human body, action of one of two kinds, which 
may be termed respectively intrinsic and extrinsic; intrin- 
sic, when they replace some normal secretion deficient in the 
patient; extrinsic, when they act as any other drug in mod- 
ifying function and tissue without relation to the nature of 
the tissue from which they have been derived. 
From Brown-Sequard’s fluid, and possibly from Dr. Ham- 
mond’s preparations, and others of like nature, effects of an 
extrinsic nature may be produced ; but the effects of intrin- 
sic nature can only be derived from preparations of secret- 
ing organs, that is, such preparations as thymus-extract, 
thyroid-extract, and pancreatic-extract. Even these latter, 
however, while they will have a large and extending field 
of usefulness in such diseases as anemia, lymphadenoma, 
rachitis, diabetes, myxedema, akromegaly and other errors 
of metabolism, do not and cannot cure diseases of the 
glands to remedy the deficiencies of which, they are admin- 
istered. 
To expect such action or to expect extract of brain to 
cure brain disease, extract of heart to cure heart disease, 
extract of kidney to cure kidney disease, is to desert the 
•solid ground of experience and the steady light of science 
to follow into the bogs of mysticism the Jack-o’-lantern of 
savage superstition.