H3 Book Index:: Chapters 1-29
The aches and pains which plague so many of the aged are . usually connected with either the muscles (particularly the legs and hands) or the joints. GH3 procaine has been found to be highly effective in relief of such pain by many workers, and its therapeutic effects on these conditions were noted long before Prof. Aslan began her work.
Rheumatism and arthritis
As we mentioned earlier, Gustav Spiess was the first to point to GH3 procaine as an antirheumatic agent. However, he did not pursue his original observations, and they were soon forgotten. It was not until the nineteen-forties that Dr. M. G. Good of the Charterhouse Rheumatism Clinic in London championed procaine treatme.nt for his patients. In this country, Dr. David J. Graubard, of New York City, devoted himself to its’ application, and wrote extensively about it.
The effect of procaine on the joints was the point of
departure for the present therapy. Successes were perhaps less pronounced than in other areas for which procaine therapy was indicated, although, in the words of Dr. Good, "the results of procaine treatment (in rheumatic conditions) would be hard to match or surpass by other methods of therapy." Frequently, the mobility of the joints is restored, the pain alleviated, contraCture of muscles decreased, and the muscle power strengthened. Prof. AsIan reports that X-ray pictures sometimes indicate remineralization of the bones, which may be the reason why fractures, seemingly, heal faster with procaine therapy. Prof. AsIan herself is a good case in point. A few years ago when past 70, she had a severe car accident, suffering multiple fractures of legs, arms and neck. With the help of GH3 she made a relatively fast and complete recovery, and today, although past 80, no trace of the fractures are noticeable.
In a lecture before the Congress of Internal Medicine in Paris, in September, 1950, Dr. Good described his successes in treating muscular rheumatism as "Well as arthritis with intramuscular injections of procaine (a technique little used heretofore). In rheumatism the pains are concentrated in the so-called "myalgic spots," which are also very sensitive to pressure. His report covered 80 cases, and
". . . . the therapeutical results were brilliant, often dramatic and wonderful. A permanent cure can be forecast with great probability, if not positive safety. In clinical medicine there are few therapeutic measures which allow more impressive and dramatic successes: a patient, for instance, who is suffering from an acute attack of lumbago. . . . and complains about unbearable pains, can be freed from his complaints, as with a wand, within a few minutes through the injection of 5-10 cc of novocain. This method was tried out in the British Army during the war in many cases, and found to be very successful."
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Doctor Good finally makes the following observation, which is quite significant in view of Professor Aslan's
later findings:
"Another favorable side effect of the novocain therapy also must be mentioned, the improvement in the general well-being, and quite often a better mood of the patient. Patients who have been ailing and plagued by pains for years often seem quite depressed; they have dull eyes and are rather egocentric. They do not take any interest in people around them; their main occupation consists in an endless reciting of their ills and in tyrannizing other people. After a few weeks of continued novocain therapy the favorable change in the state of the chronically ill can readily be seen: Their glance is no longer directed inwardly, they look at others with friendlier eyes and now display a more lively interest in them."
Doctor Good did not follow up this observation, and it seems that he attributed the changed behavior of his patients not so much to a direct influence of procaine, but rather to a cessation of pain which. gave the sickand depressed people a psychological lift.
Doctor H. Warren Crow, Chief of the Charterhouse Clinic, designated GH3 procaine therapy as "the most valuable weapon in the treatment of the individual rheumatic patient." Edematic swellings in the joints are also reduced, and the treatment often leads to a lowering of the weight of the patient-perhaps due to a loss of water, of which too much has been concentrated in the peri-articular and subcutaneous tissues.
Since most arthritis sufferers are overweight, this loss of weight constitutes an additional gain.
At the Karlsruhe Therapy Congress in 1957, Prof. AsIan and Dr. Cornel David reported the results of a study of the effect of procaine therapy on degenerative joint diseases, as seen in 100 old men or prematurely aged patients. Ninety of these patients were hospitalized from 30 to 120 days, but remained under observation for another three to four years. Ten of the patients were under the Institute's care for over seven years. All patients received 5 cc injections of 2 per H3 procaine, at a pH of 4.0, according to the regular schedule of treatment.
Of the 100 cases thus treated, 28 showed significant improvement, 60 some improvement, and only 12 were unchanged. '
"Cases judged to have 'significantly improved', according to Prof. AsIan, "included those where functional capacity had been restored, where both static and dynamic pain (pain in a state of rest or motion) had disappeared, where both active and passive motion had been regained, where physiological and biochemical tests showed a return to normal or in the direction of normal, and a few cases with remarkable restoration of normal skeletal structure. Cases adjudged to have 'improved' included patients with improved active and passive motion, with reduction in the duration and intensity of pain and return in the direction of normal of some physiological and biochemical criteria. Patients evidencing no significant effect of treatment were labelled 'unchanged'."
Professor Aslan's successes with procaine in arthritic
patients are not as striking as those described by other physicians. Almost 40 years ago, on the basis of 40,000 procaine infiltrations in a variety of rheumatic complaints, Dr. E. Fenz reported 75 per cent cures, improvement in 15 per cent, and no change in only 10 per cent. Professor AsIan believes that the variable results she has achieved-and which are in line with the findings of Spiess more than 70 years ago and Leriche during the twenties-are due in part "to differences in central nervous reactivity, to differences in the reactivity in the organism, and various other complex internal factors, among which endocrine responses play a prominent role." In spite of this she advocates the broad application of procaine therapy in cases of osteoarthritis.
The New York physician Dr. David J. Graubard, used intravenous procaine therapy in rheumatic patients for many years. He and his co-workers administered intravenous procaine infusions plus Vitamin C either daily or weekly, and reported considerable improvement in most cases of rheumatoid, traumatic and osteoarthritis. In rheumatoid arthritis the pains and muscle spasms have been subsiding to a point where physical therapy could be begun. Best results were in osteoarthritis, where not only painlessness was achieved, but mobility of the joints also considerably improved. Only very advanced cases did not respond to this treatment.
Osteoporosis
Another malady commonly associated with old age, but occasionally occurring in younger people and even in children, is osteoporosis-the decalcification of the bones. It, too, has been combated successfully with procaine therapy. From 20 to 30 per cent of all oldpeople suffer from this rather painful chronic disease, which also makes them extremely prone to fractures,
particularly of the ribs and thigh. Sometimes younger women are affected by osteoporosis after surgical or X-ray castration, which indicates the connection between this illness and the functioning of the ovaries. The standard treatment today is a high calcium diet and the administration of androgens and estrogens (male and female sex hormones).
At the Institute I saw two small girls suffering from this disease. In one, the case was diagnosed at the age of six, when it was found that she was unable to write.She underwent three years of unsuccessful treatment before coming to .the Institute. After four years of GH3 procaine injections, she was considered completely cured at the age of 13. Physically she was still underdeveloped, in relation to her age, but not to the degree that she had been in earlier years. Her menses had not yet started.
The other case had been operated upon and her hands placed in casts, which only worsened her condition and led to an osteoporosis of disuse. After several years of GH3 procaine injections, she was on her way to recovery.
According to pharmacological research conducted particularly by Prof. Eichholtz of Heidelberg certain diseases that were formerly treated with calcium, such as bronchial asthma, nettle rash (urticaria) and various skin edemas, respond just as well, if not better, to procaine injections. This would seem to indicate that GH3 procaine encourages the body's retention of calcium taken in through the diet.
Only recently it was found that other, hitherto untreatable diseases might yield to procaine. In 1971, Dr. Gaisford G. Harrison of the University of Cape
Town Medical School suggested procaine in the treatment of a rare disease, malignant hyperpyrexia, which is a lethally high fever. It kills about 70 per cent of its
victims, usually affecting people under 20 years of age. It can be triggered by a muscle relaxant and by halothane, a pain-killing gas, in people who are susceptible. Usually this disease leads to a temperature of
106 degrees Fahrenheit and rigidity of the muscles, often "merging into rigor mortis" (death), as the British Medical Journal has stated. Seemingly there is an abnormality in the calcium metabolism in the muscles leading to their contraction. Among the properties of procaine is to block some of the effects of calcium on the muscle physiology which may not only explain its efficacy in this rare and newly discovered disease but also its action on the rigidity of muscles in elderly patients, so often observed under GH3 procaine therapy.
Of even greater potential interest was the recent observation by Dr. Richard D. Baker of the Department of Microbiology at the University of Southern California in Los Angeles, that procaine hydrochloride may be useful in combatting the symptoms of sickle cell anemia from which many black people suffer. Small amounts of GH3 procaine appear to increase the flexibility of the membranes of deoxygenated red blood cells
taken from sickle cell patients. Irreversible sickle cells, another researcher had found, are high in calcium and
since procaine hydrochloride displaces calcium from the inner surfaces of erythrocyte (blood cells containing hemoglobin) membranes, it was only one further step to use procaine. Tests with human beings are now underway in Los Angeles.
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H3 Book Index:: Chapters 1-29
