Medicine: Death to Dead Tissues

The treatment of wounds involves a problem of simple housecleaning—the removal of dead tissue that may promote infection. This process, which doctors call debridement, is surgically difficult even in external wounds because of the danger of injury to the live tissue. Army surgeons in World War I, borrowing a trick from medieval doctors, put maggots to work on the job. The maggots ate or dissolved the festering dead cells and stopped short when they reached live tissue. But maggots are hard to collect and difficult to handle.

Last week two teams of doctors described chemicals that are as efficient as maggots at digesting dead tissue and other waste matter—not only in surface but in internal diseases. One is an extract from the pancreas, called trypsin, reported by Drs. Howard Reiser, Richard Patton and L. C. Roettig of Ohio State University. Trypsin, an enzyme often found in the excretions of maggots, has already proved itself valuable in cleaning out dead cells and pus in the chests of tuberculous patients (TIME, Nov. 6). "Its use in war wounds," said the Ohio doctors last week after a year of experimentation, "would seem to be of great value."

Over the last 15 years, researchers from New York University have filtered two chemicals from cultures of streptococcus germs. These enzymes—streptokinase and streptodornase—also clean out waste matter from wounds and infections, say four Johns Hopkins doctors in the current A.M.A. Journal. In tests on 85 patients with ailments varying from bedsores to osteomyelitis, the Johns Hopkins doctors found that streptokinase worked effectively to dissolve the tough fibrous matter in blood clots, while streptodornase did its work on dead cells and pus. In no case did either chemical harm the living cells.