Lucius Duncan Bulkley

“ Thus, all are pretty well agreed that cancer is not contagious or infectious, that it is not caused by a micro-organism or parasite, that it is not wholly due to local injury, that it does not appertain to any particular occupation, that it is not hereditary to any great degree, that it does not especially belong to or affect any particular sex, race or class of persons, nor is it confined to any location or section of the earth, and that it is not wholly a disease of older age. ”

“ They, therefore, turned the cancer cases over to the surgeons, in the hope that they could do better.
By the brilliant advances in modern surgery along many lines, the laity also have become obsessed with the idea that it has limitless power in many directions, and have yielded to the knife in spite of the rising mortality of late years. The glamour of modern surgery and its often spectacular results have quite blinded the eyes of many to real facts. ”

“ NATURE OF CANCER It may be safely said that no disease which has afflicted mankind has received as much attention as Cancer, or concerning which there has been as much diligent search to find out its nature and cause. Tuberculosis, which seemed at one time to threaten even the existence of the race, has sunk into relative significance, as we have learned its true nature and conquered some of the causes of its ravages, and reduced its mortality very largely. ”

“ The cancer problem is by no means yet solved, but I think that you will all agree with me that we are on the right track, and I cannot do better than to close with a remark I made to you two years ago: “Scientific research must still go on in the laboratory; but clinical research and study, with laboratory work, on the human subject, which have not been hitherto sufficiently cultivated, should be pushed, so that by a mass of carefully recorded observations the truth or falsity of what has been here quoted and said may be refuted or confirmed.” ”

“ Having now seen how very much can be accomplished in primary cases, that is, in those who have not been submitted to an operation, let us consider what can be done for those truly pitiful cases where surgery has been tried and failed, and where one or many successive recurrences after repeated operations has left the patient even worse than before; and, as some surgeons tell us, worse than the patient would have been if the disease had been left to nature, without operation and with only ordinary medical guidance. ”

“ For the ordinary requirements of the system, in health, the appetite serves as a guide, which should suffice in man as in wild animals, to preserve the balance of nutrition. But man has also the power to gratify the taste, which must be recognized in our study as distinct from the satisfying of the appetite; and the refinements of civilization have added so greatly to the temptation of wrong and over-eating and drinking, as they have to many other temptations, 109that it is questionable if reason, and what is often spoken of as the natural instinct for food, can be trusted in mankind. ”

“ When we speak, therefore, of the influence of food in the production of cancer it must be understood that it is not claimed that the diseased process depends wholly and exclusively on the character of the food, including drink, taken. In my former lectures I tried to show that cancer was the result of a deranged nutrition, and we know that one of the greatest elements in inducing this latter is erroneous metabolism, depending again on the diet, to a very great extent. ”

“ Cancer is but a deviation from the normal life and action of certain of the ordinary cells of the body, which, for some as yet unexplained reason, take on an abnormal or morbid action; with this there is a continued tendency to a malignancy which invades contiguous tissue, and in the end tends to destroy life. ”

“ From our study of inoperable and recurrent cancer, and of metastasis and the blood conditions in the disease, we see what a formidable task is before one who would attempt to lessen its morbidity and mortality. We see also how blind all have been who have so long looked to surgery to stay its progress. In my former lectures I collected and quoted statements from many surgeons of prominence in times past, and even some in quite recent times, all expressive of a belief in a constitutional origin of cancer, and many of them looking to a dietary cause. ”

“ It is a disease of sub-oxidation, and all the hygienic elements of importance in tuberculosis are equally necessary in cancer; fresh air and sunlight with, as far as possible, an ideal regulation of life in all its aspects, are indispensable.
Inasmuch as there is no specific medical antidote for cancer, and we cannot be certain of securing at once the metabolism of health, it is wise to remove and to keep away from the system those articles which have been shown to have more or less influence in its production, namely, animal proteids, coffee, tea, and alcoholics. ”

“ Climate and Locality.—There is no evidence to prove that climate has any influence in the production of cancer, nor is it affected by locality; the disease occurs in hot, warm, temperate, and cold climates, and in every possible location on the earth. But it is undoubtedly most prevalent in temperate regions, for the reason that it is in these that modern civilization, with all its faults and foibles, is most highly developed. ”

“ The United States, unfortunately, has not kept the vital statistics of the country in years past with anything like the fullness and accuracy which has obtained in England, nor even at the present time is it possible to learn definitely the frequency and increase of cancer in every locality. But all the statistics which have been gathered show unequivocally that the disease has steadily increased in a manner which is alarming. ”

“ As yet we know little or nothing in regard to actual cancer-genesis; no one has ever demonstrated, and probably no one ever will demonstrate, the absolute beginning of the change in some normal cell or cells, in the breast or elsewhere, which eventuates in their taking on the rampant or malignant feature which we call cancer. But this change does occur, and though the exact alterations in the polarity of the cells and the disturbance of their centrosomes and nuclei, which have been described, may not be perfectly understood, there is some definite cause for their occurrence. ”

“ It is to be remembered that the advance of civilization, and the facilities of transportation and cold storage, have brought from far and near an innumerable number and variety of articles for food and drink, including condiments, which bear no relation to the few simple articles formerly consumed; even the fruits which we eat are rarely ripened fully by nature, but are picked more or less green, and undergo an artificial ripening without the action of the sun, which is really akin to decay. ”

“ Most careful and prolonged study of the patient in every respect has shown a certain uniformity in regard to particular deviations from health, the correction of which has been followed by a complete disappearance of tumors classed as malignant, so that the connection must seem obvious to an unprejudiced mind. And yet it cannot be claimed that the exact, single cause of the cancerous growth has been demonstrated, 262and from the nature and character of the systemic disorders found, it is evident that there can never be any single remedy which can be rightly claimed as a cure for cancer. ”

“ To effect this we must study the human being in all relations of life, must know the constitution and class of subjects in which the disease is most apt to manifest itself, understand the chemico-physiologic actions going on in the system, before and during the existence of the disease, and by a process of synthesis and deduction understand what is wrong and endeavor to correct it. ”

“ But, gentlemen, many great surgeons, in past and present time, as quoted in my former lectures, have acknowledged verbally and in writing their inability to cope with cancer as a disease, and have recognized time and again that they operated only because they knew of nothing better to do. Often it is acknowledged that the operation is only palliative, in the hope, alas, how often futile, that some good might result from it, in the chance that the dread disease would not return. ”

“ From the enormous work which has been done on cancer with the microscope and the test tube, it would seem sometimes that research workers have become somewhat myopic, and not farsighted enough to recognize the true value of statistical studies and clinical observations. ”

“ There is, of course, no single medicine which can cure cancer, but proper medication plays a very important part in overcoming the disease and should never be neglected or interrupted in any case; indeed, one suffering from or threatened with cancer should be under the most careful medical guidance indefinitely, and this is especially true after the surgical removal of the tumor, or local manifestation of the morbid process, as Abernethy so strongly asserted, nearly a hundred years ago. ”

“ In our study thus far we have seen that there is much to be done for cancer besides the surgical removal of the offending mass, the existence of which is an opprobrium to medical science, which has not thus far guarded mankind against it: and until time has passed, and by right living and proper medical attention cancer has ceased to be produced, or become greatly diminished, surgery will probably be a great factor in its treatment, as its mortality statistics are constantly improving. ”

“ Unfortunately it must be acknowledged that many claims, quack and other, have been put forth in times past for remedies and measures which would control or remove, and even cure, the disease in all stages. But the failure of each in turn has very naturally discouraged many from accepting any new proposition, and the profession and laity have almost given up the hope for a real cure of cancer. ”

“ There seems to be some reason to support the view advocated by Williams, that tumor formation and growth are but forms of agamogenesis, or non-sexual reproduction of cells, distinctly related to the decline in growth of the body in general. Hence while the forces of growth, development, and reproduction are in greatest activity the tendency to this disease is relatively small: but when growth declines and nutrition is relatively low the cells undergo gemmation, owing to perverted nutriment, and thus hyperplasia and not inflammation is the starting point of every neoplasm. ”

“ It may happen, therefore, that in treating a cancer patient over the long time necessary to effect a cure, the greatest number and variety of remedies may be employed from time to time, as intelligent observation and experience may indicate, to restore and hold the metabolism and nutrition in a perfectly normal state: the erroneous action of certain individual body cells which in the aggregate we call cancer, will then cease to exist, as is seen in cured cases. ”

“ METABOLISM OF CANCER In the first lecture we saw that cancer was an alteration of the normal cells of the body, whereby they take on a malignant action and continue to do so, destroying contiguous tissues and leading to a lowered vitality, with an apparent poisoning of the system, which finally causes death. ”

“ The enormous activity with the microscope in regard to the minute structure of the diseased tissues, and the elaborate and extensive work done in animal experimentation, have turned the thoughts of many from the homely and practical studies of the human frame in its various departures from health; thus too little attention has been given to the deranged activities of its various organs, and the perverted metabolism which, has resulted from the stress and strain, with the temptations and errors accompanying the present intensity of human civilization. ”

“ But every one who has been brought much into contact with cancer knows full well what a mass of recurrent cases exist, possibly many of them due to bad operation, in regard to which surgery has to acknowledge that it can offer nothing more, that they are inoperable and therefore they are regarded as incurable. ”

“ I repeat, is it not time for us to stop and consider whether our laboratory work with the microscope on morbid tissues, and our experimentation on rats and mice are truly serving to solve the real problem of cancer? ”

“ The medical treatment of cancer patients is a matter which should receive most careful and constant attention; indeed, the patient in whom cancer is threatening or has developed should be under the watchful and unremitting guidance of a physician who grasps the importance of the matter and is prepared to guard the health, and to meet and correct functional disorders as they arise ”

“ We see, thus, that cancer is not primarily a surgical affection, and that the mere ablation of an offending portion of the body which has become diseased can never preclude a new portion from becoming affected, or prevent a recurrence in the same location; indeed, this often seems to be stimulated and increased by the trauma and by the deranged lymphatic and vascular circulation caused by the operation and the dissemination of actively growing cancer cells through these channels. ”

“ When we consider the small share which nitrogen plays in the composition of the human frame, as shown in the table presented, only three per cent., it is easy to see how an excess of nitrogenous food must necessarily either pass off unassimilated or undergo imperfect metabolism, and so derange the general metabolism; and this is found to be the case in many conditions of disease, and, as has been shown, in cancer. ”

“ Finally, for our time does not permit a fuller discussion, nervous conditions unquestionably can and very often do exert a profound influence on the secretion of the various organs of the body, and can so disturb digestion, metabolism, and nutrition that the most varied results may follow, to which the names of different diseases are given; so that nerve strain, more or less incident to modern life, must be accredited with a certain share of influence in the production of cancer. ”

“ We have seen in the former lecture that cancer is not a definite something, from without, that attacks the human frame, but that it is only a faulty development and action of certain body cells, which were once normal, with a steady decline in bodily health which tends to a fatal issue in a very large proportion of those once affected with the disease. ”

“ Coming down, then, to the actual and practical facts relating to the dietary and medical treatment of cancer, we readily see 149that the real cancer problem relates to placing the patient in such a normal or ideal state of life that the function of nutrition is performed in an exactly proper manner, as nature intended, and from which man has erred through the manifold temptations incident to our artificial existence, in the presence of our so-called advanced civilization; for we have seen that all over the world cancer has steadily increased with the intensity of human progress. ”

“ I recognize that it is often very difficult to persuade patients to adopt and faithfully follow out this course of procedure for a long enough time to secure perfect results, so obsessed is the medical profession and the laity with the idea that surgery offers the only hope of cancer. ”

“ In my former lectures I attempted to show that all experience and biochemical laboratory studies looked this way, and in a later lecture I shall hope to show that by dietary, hygienic, and medicinal measures the disease can be and has been checked repeatedly, and cancer cured without surgical operation. The permanence of the cure depends, of course, upon the continued faithful adherence of the patient to the means and measures which caused the dissipation of the tumor. ”

“ Recurrence of cancer is far more common during the first year after operation than in any other single year, but, as we shall see shortly, there is no time limit when the disease may not manifest itself anew. It is understood, of course, that recurrence depends also largely on the previous duration, extent, and malignancy of the tumor, and exact statistics are very few and imperfect in regard to these matters. ”

“ I explained at the time that any attempt to excise portions of tissue for such study would at once endanger the patient and imperil the success of treatment, by giving occasion to metastases, from the opening of blood vessels and lymphatics. This matter is treated of more fully in the present lectures. It is to be remembered that the vast majority of operations for cancer are undertaken upon a purely clinical diagnosis, and it may be undeniably stated that not one half of them are confirmed subsequently by competent microscopic evidence, except, of course, in properly equipped hospitals. ”

“ The blond Nordic race, however, seems to be more susceptible to the disease than the darker races, originally of Asiatic origin; and it is the former who have pushed forward modern civilization, with all its errors of life.
Thus cancer is everywhere reported to be rare, and sometimes almost absent, in primitive, uncivilized peoples, but it has been repeatedly observed, in many localities, that as these same people mix with Europeans and adopt their diet and mode of life, cancer is sure to increase, until its frequency often about equals that in their highly civilized neighbors. ”

“ Turning to other countries, we find abundant confirmation of the persistent and considerable increase in the mortality from cancer, in many cases much greater than has occurred in the United States; and in nearly all of them the increase can be recognized as commensurate with the progress or advance of so-called civilization, especially as emphasized in city life. ”

“ Personally I believe that sooner or later it will be generally recognized that the starting point of cancer occurs in some cell or cells, previously normal, probably as the result of local irritation, in which there is a deposit of some of the elements of faulty nitrogenous partition, induced by undue ingestion of animal protein: and that the malignant, reproductive process in the cells is kept up by a continuance of the same supply of imperfectly disintegrated nitrogenous matter. ”

“ Unless much time, thought, study, and effort can be given to each case of cancer, I should deprecate any attempt to treat it medically, and rather risk at once the chances of surgery, poor as they are. ”