Malignancy

“ A carcinoma is a malignant tumour, and the malignancy is made much worse by the stimulus of pregnancy with its increased blood supply. The maternal deaths from carcinoma of the uterus during pregnancy is, according to the latest and most favourable statistics, 30 per centum. The mortality of the children is from 50 to 63 per centum. ”

“ Again, it is beyond doubt that occasionally a tumour, which for years has been void of the least taint of malignancy, may become converted into an active cancer. Moreover, certain tumours seem to lie on the border line, for example, rodent ulcers and cancers of the parotid gland. ”

“ I take, however, the liberty of stating--though not with absolute certainty--that leprosy and issue are occasionally the consequence of contamination by corpses. A dead body represents the highest degree of malignancy, and a leprous limb is as if dead. ”

“ It has a strong stimulative and absorptive power; will remove swelling, arrest development, restore circulation, and remove pain. Is indicated in all cases of malignancy where there is a tendency of the disease to spread, and where there is considerable hardness sur. ”

“ What but the most consummate impudence can allow a man to assert that he has cured a genuine cancer, when that very man does not know the nature of cancer, or point out what is, or what is not, a malignant disease?
Having thus described the nature and symptoms of cancer; and having adverted to the effect of medicine upon this disease, I shall make some remarks on the treatment of the same. I have stated there is no specific remedy known for this disease; and that those who pretend to such specific are imposters of the most dangerous description; such men will boast of "great discoveries;" ”

“ Once symptoms of this disease have recurred after efficient treatment, there is only one good reason for not looking and making certain, and that is when the risks of [76] looking exceed those of the lesion being malignant—that is to say, somewhere between ten and twenty per cent. At present, the risks of looking are about one in a thousand, and the risks of removal of a cancer about three per cent., taking all cases, most of which are at an advanced stage. ”

“ The upper part of the body is covered with frequent spots and tumours, the redness gradually changes to black, the skin is thickened, and covered with hard asperities like scales; the body wastes, but the face, legs, and feet swell; and when the disease is protracted, the fingers and toes become buried in the swelling, and a slight fever comes on, which finishes the patient’s sufferings. Such is his description of the disease. His treatment consists in bleeding at the commencement, abstinence, then supporting the strength, purging, exercise, sudorifics, and friction. ”

“ For many years I have been teaching in my lectures and writings as well as in private advice to patients that cancer is a constitutional disease; that it is rooted in every drop of blood in the body; that it is caused by the presence of certain disease taints or of food and drug poisons in the system; that these poisons irritate and stimulate the cells in a certain locality and cause their abnormal multiplication or proliferation in the forms of benign or malignant tumors. ”

“ When this tumor grows large, is of a livid, blackish, or leaden hue, and attended with excruciating pain, it is called an occult cancer; but, when it becomes a sore, or ulcer, discharging a very fetid, ichorous matter, it is then an open, or ulcerated cancer. The latter species is by far the most dangerous, and has, by the most judicious practitioners of all ages, been considered as incurable by any internal remedies: the occult cancer, however, has sometimes, especially before it had attained a considerable size, been cured by external applications, of which we shall give a short account. ”

“ In medical science, the term “malignant” is applied to a particularly virulent or dangerous form which a disease may take, or to a tumour or growth of rapid growth, extension to the lymphatic glands, and recurrence after operation. ”

“ Too often when a cancer is suspected or discovered it is taken as a foregone conclusion that the malady is hopeless, except as the results of the disease, that is the new growth, may be removed by the knife, X-ray, radium, caustics, etc. And after a surgical operation, as far as my observation goes, the patients are invariably left entirely to their own resources, with the hope, alas, too often futile, that the tumor will not regrow, but with no attempt to so guide the life that there shall not be the same tendency to a recurrent malignant new-formation. ”

“ The attacks usually pass off, and relief may be obtained naturally or by the administration of a purgative, but they have a tendency to recur and in malignant disease to increase to complete obstruction. Finally a seizure may persist and take on all the characters of an acute attack, and death may supervene from exhaustion, perforation or peritonitis, unless immediately treated. When it arises from simple stricture no tumour is to be felt, but in malignant disease the tumour may be frequently palpated, unless during an acute attack when the abdomen is much distended with gas. ”

“ That there are several cutaneous Diseases that may be propagated by Contagion, if a Person lies with another, is by all allowed of; and that the lying with a Person that has a Cancer may be attended by such a Disease, from the Proofs we have brought, I suppose will be agreed to be equally as certain. But this cannot happen unless the matter be very malignant, and be suffered, by the Negligence of the Patient, to come to an immediate Contact, with a Part of the Body of the other Person ”

“ The processes of decay of these tumor materials liberate large quantities of alkaloids of putrefaction, and these, in turn, stimulate the normal, healthy cells with which they come in contact to rapid, abnormal multiplication.
The malignant growth, therefore, feeds on its own products of decay, aside from the systemic poisons and morbid materials already contained in the blood and tissues of the body. These morbid products permeate the entire system. They are carried by the circulation of the blood into all parts of the body. ”

“ It consists in these particular circumstances, viz. that Critical Tumours or Impostumes are indifferently all such as are form'd at the End or Termination of Diseases, in whatsoever Place or Part they appear.
Malignant Impostumes or Tumours are those that are obstinate, and do not easily yield to the most efficacious Remedies.
Pestilential Impostumes or Tumours are those that are accompany'd with a Fever, Swooning, Head-ach, and Faintness: They usually arise in the time of a Plague or Pestilence, and are contagious. ”

“ Pimples arose in the skin; the hair was turned white; the plague (or sore) in sight was deeper than the skin, when the disease had been of long standing; a white tumour appeared in the skin, in which there was quick flesh; the foul eruptions gained ground daily, and at length covered the whole surface of the body. And the evil is said to infect, not only the human body, but also the cloaths and garments, nay (what may seem strange) utensils made of skins or furs, and even the [13] very walls of the houses. ”

“ The only chance of a radical cure consists, he says, in making a complete excision of the part; but in doing this he forbids us to secure the arteries with ligatures, as they will occasion a recurrence of the disease. The part, he says, is loaded with a thick, black, or recrementitious blood. When the cancer is ulcerated, he disapproves of cutting and burning.
Celsus describes carcinoma as an immovable and unequal tumour, attended with swelling of the veins, which are pale or livid. ”

“ What is a Cancer?
It is a hard, painful, and ulcerous Tumour, produc'd by an adult Humour, the Malignity whereof can scarce be suppress'd by any Remedies.
How many sorts of Cancers are there?
There are two kinds, viz. The Primitive and the Degenerate; the Primitive Cancer is that which comes of it self, and appears at first about the bigness of a Pea or Bean, which nevertheless doth not cease to cause an inward Pain, continual, and pricking by intervals; during this time it is call'd an Occult Cancer; but when grown bigger, and open'd, it bears the Name of an Ulcerated Cancer ”

“ If you are a physician, you will realise that this evil has its counterpart in human tissues, where a single cell, that differs not at all from other cells and is a natural unit in the organism, may suddenly and, as it seems, unreasonably acquire a faculty of monstrous and malignant growth, cleaving and multiplying to the destruction of its fellows—a cell gone mad, to which the ancients gave the name of cancer. ”

“ Those practitioners who do not recognise the malignant disease, and operate for every tumour, and at all ages, have boasted of great success. But it is not so with those of mature experience. The disposition to malignant action often remains latent for many months, sometimes for many years, and at length becomes fully developed. The disease may return in the skin; the cicatrix hardens, ulceration occurs, and makes progress. Or tubercles form in the cellular tissue, enlarge, and involve the skin. Or the glands become tender and swell; and the swelling is often unattended with uneasiness. ”

“ Rhases says, that they who make an incision into a cancerous part merely produce ulceration thereof, unless it be so seated that the disease can be completely removed and the parts afterwards burned. (Ad Mansor. vii, 9.) In another [334] work he expresses himself rather favorably of excision and burning. (Contin. xiii.)
Haly Abbas approves of the operation when the cancer is seated in the mammæ or extremities. He recommends us to allow the part to bleed until all the melancholic humour is evacuated, and says nothing of the cautery or ligature. ”

“ Formation of Secondary Growths, or Metastases.—In addition to this spread of growth by direct extension, another characteristic of malignant tumours is a tendency to dissemination, that is, to reproduce themselves in various parts of the body far removed from the original site; so that it is not unusual to find after death that a cancer of the breast has?given rise to secondary, or metastatic, deposits in the lymphatic glands, the lungs, the ribs and other bones, the brain and the abdominal organs. ”

“ Be thankful if they do not become coagulations and produce gangrene, be thankful if they do not reproduce the cancer!
While the patient breathes, we must not lose hope, and however late we be, a judicious examination is never superfluous; at least the cause of death may be known. ”

“ What he could do in his own suffering you must learn to do for others on whose vital organs disease has fastened its devouring teeth. It is a terrible thing to take away hope, even earthly hope, from a fellow-creature. Be very careful what names you let fall before your patient. He knows what it means when you tell him he has tubercles or Bright's disease, and, if he hears the word carcinoma, he will certainly look it out in a medical dictionary, if he does not interpret its dread significance on the instant. ”

“ He makes a distinction between the cacoethes, or malignant tumour, and the true carcinoma, but says that the difference between them is to be recognized only “tempore et experimento.” He marks the gradations of malignant disease with singular precision: first, there is cacoethes; then carcinoma without ulceration; and last, there is the fungated ulcer. (The reading in the edition of Milligan is a great improvement.) In doubtful cases he directs us, first to apply caustics or heating medicines, and, if the disease is alleviated, to proceed to the scalpel or burning, according to circumstances ”

“ In Cancers we have but little Reason to expect a Cure in a Person that is old, if the Cancer has been of many Years standing, and is firmly fixed to the Ribs; but if the Patient be not so far advanced in Years as to be uncapable of receiving the Benefit of Nature by the regular Discharge of the Menses and the Cancer be loose; notwithstanding, it be Ulcerated, over-spread with fungous Flesh, discharge a filthy Matter, and smell very offensively; we do upon Experience affirm that such a Patient may be cured. ”

“ 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. ”

“ The early signs of cancer may now be summed up as those of a lesion of some kind, extending over a number of years, giving rise to very little trouble or inconvenience, and followed by a small hard lump or ulcer. If the latter is present, it is often characterised by bleeding. Again, practically no symptoms. To find it we must look and see; often an operation involving [52] practically no suffering and a very small mortality is necessary. But the penalties of failure to do this at the proper time are that ten per cent. of the population die of cancer. ”

“ If I told you that it was a malignant tumor, that would be true, but it wouldn’t be an answer, because we don’t know the real nature and underlying cause of the tumor. Whether it is caused by a germ, science has not yet determined. But though we know nothing of the fundamental cause of the disease, we do understand, definitely, what is the immediate causative influence. It practically always arises from some local sore or irritation. ”