RANDOMIZED TRIAL OF EFFECTS OF IFN-ALPHA ON THE INCIDENCE OF HEPATOCELLULAR-CARCINOMA (HCC)

In this brief article, I have tried to lay stress on the fact that the problem of puerperal infection is almost entirely anatomical, depending on anatomical pathways for its spread, on physical and mechanical phenomena of stasis, drainage, etc., on cellular reactions called forth for defense, etc., and has very little to do with fancy theories of immunity, selective affinity of certain strains of bacteria for certain tissues, etc.In addition, the condition of septicemia, which denotes only the ability to recognize bacteria in the circulating blood, is in many of these cases intermittent, and, at times, does not exist. I have endeavored to enumerate the anatomical reasons for this assumption.In other words, bacteria do not multiply and grow in the blood but are discharged into it from either primary, secondary or tertiary depots in the various organs, in usually an intermittent fashion.When thrown into the circulating blood, nature makes every effort to quickly rid the blood of their presence through its organs of elimination and filtration. The application of chemotherapy in the intravenous injections of mercurochrome, gentian-violet, and other like substances, is only excusable on the premise of attempting to kill those organisms circulating in the blood at the time of the injections, and to thus prevent the establishment of secondary foci in other parts of the body. As one is unable to know when the blood is being showered, the hopelessness of such procedures seems convincing.Medication is, then, of no avail; vaccines and sera are equally useless. Only supportive blood transfusions seem to be of any benefit. I am not competent to discuss the value of artificial fever or heat produced by physical means.Williams 2 states, “In such cases prayer is the best treatment, and the better prayer a doctor is, the better his infected patients do.” The more radical the treatment the higher the mortality. The best results are obtained by those who do the least.While the anatomical view of the subject leads one immediately to the possibility of radical surgery in its irradication, the obvious difficulty in knowing how far the process has extended greatly restricts surgery to the incision and drainage of localized collections of pus (for instance, an abscess pointing above Poupart's ligament), and in rare, selected cases where either the immediate ligation of thrombosed veins or a quick hysterectomy for a uterus containing multiple abscesses, might be seriously considered. According to Williams the latter two surgical procedures were in his experience indicated only once in every few years.Finally, although this paper has been somewhat limited to the infections of the female pelvis, the general anatomical considerations, in the main, are applicable to other pyogenic infections, more especially to those of the middle ear and accessory sinuses of the head and to infected wounds of the extremities and trunk; the difference lying only in the type of tissues affected.