extensive trip I was not able to see or hear of any cancer in the rice
eating countries of the East, in Japan, China, India, Siam, and Egypt;
although I understand that there is some malignant disease among the
natives who adopt foreign habits, or who eat more or less meat, pork,
etc. With this experience in view I have sometimes placed certain cancer
patients, for a longer or shorter time, on what you are familiar with as
my “rice diet,” and with manifestly beneficial results. I would not, of
course, push it or continue it too long, but as a means of making an
impression on a full blooded person, with beginning cancer, and as a
means of facilitating the exclusion and elimination of nitrogenous
elements from the system, it has sometimes served a valuable purpose. I
also continually rather urge the consumption of rice by cancer patients,
as largely as possible, even daily, in place of other cereals.
In regard to the medicinal treatment of cancer it is difficult to be
clear and definite, and yet concise within the limits allowed for a
lecture. For, as you may imagine from what has been said in these and
the previous course of lectures two years ago, there is no one remedy or
even any single course of treatment which is to be invariably followed
or is always successful in every case of cancer.
In a disease of such uncertainty as to its definite causation, and of
such obstinacy and duration from its first inception, the remedies which
may be required in different cases are as varied as are the
peculiarities of the individual. The treatment requires the utmost
diligence and solicitous care and attention to details on the part of
both the physician and patient, and over a period of time which it may
be difficult to secure. This is rather a different proposition from that
of a relatively brief surgical operation, after which the patient is
dismissed with the hope that the disease will not recur!
Patience and perseverance, with medical acumen, are the first
requisites-but before this there must be a belief and confidence in the
truth of the statements, the correctness of the theory, and the value of
the method to be employed; with this there must also be an optimism on
the part of the physician which begets a confidence in the patient,
which will do much toward reaching the desired result. 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. It was for fear of harm following
an incomplete understanding of, and an imperfect or careless carrying
out of the line of practise which I had pursued satisfactorily for
thirty years and more that I hesitated and delayed so long before urging
it generally. But the steady rise in mortality under the ordinarily
accepted treatment has impelled me to strive to make clear what I
conceive to be the correct view of its nature and cause, and the
approximately correct treatment of cancer.
From what has preceded in these and former lectures it will be seen at
once that rational and right internal treatment must proceed and
continue along the lines previously indicated relating to the
biochemistry of cancer. Some tissue cells have taken on wrong and
rampant action, of a reproductive character, owing to an erroneous
metabolism, which has induced a deranged or disordered blood current,
and some measures are to be devised and carried out to restore the
bodily functions to a normal state.
The first line of medical treatment, therefore, after preventing the
introduction of animal protein, coffee, and alcohol by dietary measures,
is to seek to restore to normal the various bodily secretions and
excretions. The urine, by repeated, complete, volumetrical analysis,
serves as a constant guide along many lines, which I considered pretty
fully in the former lectures and need not repeat now. In one private
case of cancer of the breast the total amount of urine passed each day
was measured and recorded daily, almost without an exception, for a
whole year, and specimens of the same were carefully analyzed and
studied almost every week. The total quantity of solids, which was at
first only one half what the body weight called for, was brought up to
about normal as the condition of the patient improved.
It is impossible in a single lecture to tell you of all the indications
and teachings which may be learned from the urine, much of which must be
acquired by close observation and experience. The urea is almost always
diminished, and this indicates an imperfect anabolism of the body cells,
as the urea represents the final metabolism of their nitrogen. Uratic
deposits are not uncommon, but other evidences of faulty nitrogenous
metabolism also occur, free uric acid, ammonia, aromatic oxyacids, etc.,
whose individual significance in relation to cancer it is hard to trace,
but clinically these derangements seem to have to do with the virulence
of the disease. Indican in excess, and often greatly increased
sulphates, are common, evidencing disturbed intestinal action. All these
and other abnormalities, having to do with a deranged blood current, are
to be rectified by proper treatment, the minor details of which cannot
be elaborated in a single lecture.
I have told you that imperfect intestinal excretion and constipation are
almost invariably found in the subjects of cancer, even in very early
stages and long before they have been induced by opiates given for pain.
I may here remark casually that even in severe inoperable cases up to a
fatal ending, I seldom have to give morphin when the patients are under
a full and complete line of dietary and other proper treatment; these
latter seem to so change the character of the blood stream, or act in
some way so that there is not the pain previously suffered. Possibly it
is in part through lowering the blood pressure.
The subject of intestinal stasis or constipation is, with urinary
derangement, such a very large one that it cannot be fully compassed in
a single lecture. So I shall take the liberty of speaking dogmatically
and shall tell you more or less definitely what observation and
experience has taught me to do along these lines of faulty urinary and
intestinal action in cancer. And really you will find it similar in many
respects to the lines of theory and practise which I try to develop for
you in connection with certain diseases of the skin. For, after all, in
many conditions of disease we are to treat the patient in regard to a
disordered system, and not always so much the particular disease by
name. You will also remember that I have told you how it was by
observing certain breast tumors which had been diagnosed as cancer by
competent surgeons, urging immediate removal, disappear without
operation under such treatment as I was giving for other complaints,
that led me to my present point of view and practise.
In regard, then, to the actual medical treatment employed I may say that
in the Skin and Cancer Hospital, and also in private practise, these
patients are almost always first given a certain mixture with which you
are familiar, ℞ Potassæ acetatis ℥, Tinct. Nuc. Vom. ℥ss, Extract.
Cascar. fl. ℨi-ℨv, Extract. Rumicis radicis fl. ad ℥iv, the amount of
cascara being varied according to the action of the bowels, which should
move freely twice daily. This commonly acts also somewhat on the urine.
This mixture is always taken three times daily, half an hour before
eating, in one third of a tumbler of water.
It is interesting to note that Forbes Ross, a London cancer surgeon,
whose untimely death has deprived us of a valuable scientific worker
along our present lines, was an ardent advocate of potassium in the
treatment of cancer, whose value he established on biochemical as well
as clinical grounds. He, however, pushed the administration of the salts
of potassium far in excess of that which I have found necessary. He has
related instances of advanced cancer in which the results were
remarkable, and one of them, a case of cancer of the uterus in a widow
aged 59, was quite a counterpart of one which I shall narrate to you
next week. I wish I could give you _in extenso_ some of the remarkable
arguments from microscopic and chemico-physiological study which he
gives, to explain how potassium has such a controlling effect on cancer
cells; but it is quite out of the question in a lecture such as this to
enter fully into every enticing field of inquiry, and I must refer you
to his valuable work. I am quite aware that when published this book was
the subject of some criticism and even ridicule, but reviewers could not
have properly grasped the whole book, which was simply so far ahead of
the times that it was not understood. Cancer was then, even more than
now, in the grip of the surgeon, who resented any thought of treatment
other than by the knife.
Dr. Ross had operated much in cancer, but, realizing the inefficiency of
surgery to cure the disease, he wrote very severely in regard to cancer
surgery in the opening chapter of his book. After “ten years of constant
microscopic, clinical and surgical research,” he advanced the hypothesis
that “cancer is due to a want of balance in particular mineral salts of
the body, and that the disturbance of this balance leads to the
disorderly and malignant growth of epithelial cells (epiblastic and
hypoblastic) which is professionally known as Cancer or Carcinoma,” and
that the main disturbance is in regard to the potash balance in the
body. By very careful deductive and inductive reasoning, and by actual
experimentation and practise he shows how this answers and explains more
of the puzzles and intricacies of the cancer problem than any other
hypothesis. In the previous chapter I referred somewhat to his
interesting studies on cell polarity, the red blood cells, and the
probable rôle of mononuclear leukocytes in inducing cancer-genetic
changes in the tissues.
Pardon this rather long reference to Dr. Ross, who was much
misunderstood by his fellow practitioners because of his blunt
expressions and his presentation of a new thesis regarding cancer, which
was not grasped, and, as far as I know, has been neglected by the
profession; his book was published in 1912, and has only rather recently
come under my notice. He died the following year, but at the end of the
book, three months after it was written, he added a note stating that
“all the cases described therein have continued to improve under
treatment, until some of them have practically ceased to be cases of
recognizable cancer.”
It is, therefore, not a little satisfactory to find from a cancer
surgeon such microscopic, biochemical, and clinical explanation and
support for the treatment which I have followed for thirty years and
more, and which I am now presenting for your consideration. Dr. Ross
makes three references which in a measure support the potassium theory
of cancer.
1. “The old physiological adage ‘Potassium is the salt of the tissues,
and sodium the salt of the fluids of the body’ still holds good as an
absolute physiological truth.”
2. “Animal physiology teaches us that the whole range of the animal
creation, from an ameba to man, follows the same law, ‘Potassium is the
salt of the tissue cell.’”
3. “Examination of the botanical world brings us face to face with the
same identical statement ‘Potassium is the salt of the chemical
physiology of the vegetable cell.’”
The first treatment, therefore, which is given to these patients is
potassium acetate, as previously mentioned, in combination with nux
vomica, and some cascara, and rumex fluid extract; this latter is one of
the old alternative remedies which I have used for years with most
favorable results in certain skin diseases. In some of the cases related
two years ago and in some of those I shall report in the next lecture,
this mixture, with little variation, has been employed almost from the
first to the last, with occasional alternation with other remedies. Dr.
Ross has used principally the citrate of potassium and phosphate of
potassium combined, which he gave in doses up to 90 grains per day, and
even more. I have quite recently used the same, though in smaller doses,
but it is too soon to report any results, and do not know if they will
serve better than the acetate, which I have so long employed. Dr. Ross
makes the interesting statement that, having used enormous quantities of
potash salts in his practise for fifteen years, for various complaints,
not one single case of cancer had ever to his knowledge occurred amongst
the clientele of his own practise, though he had constantly been engaged
in operating on cancer sent to him by other medical men. I made much the
same remark in one of my former lectures (p. 152), though I did not
ascribe it wholly to the acetate of potassa which I have long used so
freely, but to the additional normal salts which I got from a strictly
vegetarian diet.
I would not have you to understand that this is all that is to be done
medically for cancer patients; on the contrary, as the case goes on over
a period of time, a thousand changes may be necessary to meet symptoms
as they present themselves. And here arises the difficulty of making
exactly plain wherein lies the successful internal treatment of cancer;
for unless just the proper care is given at the right time all may not
go well. For this reason these patients should be seen at least once a
week, and for months, and the exact state of the system learned by
volumetric analyses of the urine and occasional studies of the blood, in
addition to the ordinary watching of the pulse, tongue, sleep, mode of
life, exercise, fresh air, absence of worry and nerve strain, diet, etc.
Iron is a very important element in the treatment of these patients,
though sometimes it will be found difficult to have it rightly taken and
properly assimilated. I have come to use largely the pyrophosphate of
iron in powder, in five grain capsules after meals, in conjunction with
the mixture referred to, half an hour before meals. Sometimes dialyzed
iron, half to one teaspoonful in water, taken in the middle of the meal,
acts best, though I prefer the pyrophosphate, as phosphorus in some form
should always be given for some time to these patients; it is to be
remembered that the iron, potassium and other elements of the blood
cells are united as phosphates. Occasionally I have to give the acetate
of potassium with nux vomica and infusion of quassia after meals, in
place of the other mixture, which after a while may be distasteful. But
remember that potassium is the sheet anchor, and also that in some way
the solids in the urine must be kept up to the standard of health, as I
mentioned in a former lecture, which I occasionally accomplish by adding
sweet spirits of nitre, etc.
I have emphasized imperfect intestinal action as a most important
element in the probable causation of cancer, and the regulation of this
function will often require the very greatest care, patience, and often
even ingenuity on the part of the physician. The stools should really be
frequently inspected. It is not enough to inquire at each visit if the
“bowels are regular,” but the matter must be patiently investigated, as
to the character, quantity, color, odor, hour of defecation, which
should be after breakfast, etc. Nor is it enough just to order
purgatives or laxatives from time to time, but such attention should be
given, and such remedies and measures applied, as will secure the best
possible performance of this most important function. The mixture just
spoken of, altered as required in regard to its cascara content, will
often suffice, but many of my patients also secure a full and free
intestinal relief each week, by means of the old pills which you hear me
order so often in this clinic: ℞ Massæ hydrargyri, Extr. Colocynth.
Comp. āā gr. x, Pulv. Ipecac. gr. ii. M. Div. in capsules No. IV. Take 2
at bedtime and 2 the second night after. I also use greatly the
excellent combination of ℞ Podophyllin, Cascarin, Aloin, āā gr. ¼, M.
one or more of these at bedtime, as needed. I do not approve of mineral
waters or saline laxatives in these cases, nor of mineral oil, and never
employ enemata, except for emergencies.
I hope I have not wearied you too much with these homely details, but I
assure you, gentlemen, that they are not in vain, and I only wish I
could go over these and other matters yet more minutely. My experience
with cancer for years has taught me well its seriousness, which I have
no desire to minimize. Its dietary and medicinal treatment is no small
matter to undertake, and should never be lightly entered upon. When the
diagnosis of cancer has been definitely made by one or more medical men
or surgeons competent to do so, the patient unfortunately is fully
imbued with the very serious character of the malady, and most of them
know well of the very slim chances of a permanent cure offered by
surgery.
Few know, however, of the hope of a cure which can be extended to them
by dietary and medical means, if they are perfectly faithful for an
indefinite length of time, and if the case receives adequate and proper
medical attention. It is for those of you who have heard these and the
former lectures, and have seen the cases, to act with confidence and
assurance, and give the utmost diligence and attention to details in
order to obtain similar results; for I assure you, gentlemen, that
thereby you can secure a success in cancer which is many times that
following the practise of surgery, judging from the distressing and
steadily rising mortality records up to the present time.
Do not be discouraged with apparent want of success at first, especially
when you are treating inoperable or recurrent cases—for those are always
depressing. But with more recent cases, such as I have reported in the
former lectures and will mention in my next lecture, you may be pretty
sure that if every feature of treatment is perfectly carried out you
will attain a measure of success which is very gratifying.
LECTURE VI
RESULTS: PERSONAL CASES
Two years have elapsed since I said to you in the last lecture of the
former course, “The test of everything lies in the results obtained.
Theories, discussions and arguments are all unavailing unless results
show their truth.” I can now repeat the same phrases after two years’
further observation and experience. And I can also speak much more
strongly than I did at that time, not only after testing the matters
then presented further, in private and hospital practise, but also after
an amount of study of literature which I should hardly have thought
possible some years ago.
First I want to recall to you the report of the interesting and
remarkable case which was made at our last lecture by Dr. C., one of
your number, who promised that if possible the patient would be
presented at a later lecture. This was in the person of a lady, now
about fifty, seen nearly ten years ago, who presented a great mass of
disease in the lower abdomen. On consultation it was decided to attempt
an operation, which was performed by Dr. ——, a well known surgeon. On
opening the abdomen there was found an amount of malignant tissue,
involving many organs to such a degree that it was decided that no
removal was possible, and the wound was closed, after securing a section
for microscopic study. This was examined by Dr. H., a well known
pathologist, and found to be sarcoma.
About that time, nine or ten years ago, I had briefly spoken in one of
my lectures about the value of an absolutely vegetarian diet and medical
treatment in cancer, and Dr. C., thinking, as he told us, that it might
possibly be of advantage to her, in prolonging life or perhaps making it
more comfortable, placed her upon it. He has followed the case up to the
present time, and stated to us that there was now no evidence of the
disease, the abdomen being normal under every examination possible.
Surely one such case should be sufficient to direct serious attention to
a plan of treatment capable of securing such a result in a patient who
is now living in comfort, nine years and more after the surgical removal
of the tumor was found to be impossible, and who would otherwise have
been dead long ago.
In my former lectures I detailed eight cases of undoubted breast cancer,
verified by surgeons, some of them well known, in which the results
obtained by the methods I have been presenting were most gratifying, and
I need but refer you to the account of them given in my book in which
the lectures were published.
You will perhaps remember that the first two cases had been followed up
for sixteen years and had remained well, without operation; the next two
cases, curiously enough, had each been observed for over nine years, and
as they are still under my medical care for various complaints I can add
two years more, making over eleven years that they have remained well,
without operation.
In those lectures I stated that I had recorded on my books in private
practise a total of 744 patients with Epithelioma, Carcinoma, and
Sarcoma. I now find recorded in private and hospital practise a total of
196 cases of carcinoma, 36 of sarcoma, and 685 of epithelioma, a total
of 917 cases of malignant disease. There are also records of some dozens
of cases of adenoma, cysts and chronic mastitis, etc., of the breast,
besides fibroma, lipoma, angioma, papilloma, etc., generally benign in
character, in various locations, all of which are, of course, excluded
from our study.
EPITHELIOMA.—Although epithelioma of the skin is included with cancer in
the Mortality Tables of the United States and elsewhere, I do not
purpose to admit it in connection with the results of treatment of
cancer, for several reasons. First, Because cutaneous epithelioma
occasions but a very small proportion of the deaths from cancer,
something over three per cent. Second, Because its cause and treatment
are almost entirely local, and so it does not relate greatly to our
general inquiry as to the internal or constitutional cause and treatment
of real cancer. Third, Because dietary and medicinal treatment seem to
have relatively little, if any, effect on cutaneous epithelioma, except
in the later stages, where the disease has caused great ravages, and
lastly, Because if the proper treatment of cutaneous epithelioma is
begun early and carried out faithfully it need never, or exceedingly
seldom, acquire a severity such as is often depicted by overzealous
surgeons who advocate only the knife.
In regard to epithelioma on the skin and also on the tongue, lip, and
oral cavity, however, I want to give you one word of caution, and that
is in regard to the use of nitrate of silver. I have seen so many
epitheliomatous lesions in these regions which have been goaded on to a
severe degree of ulceration by the injudicious and meddlesome “touching
up” of the same with nitrate of silver, that I would make it an axiom to
never use this superficial caustic at any time in connection with
anything which may possibly be epithelioma. I would almost consider it
criminal to do so. On another occasion I may take up the subject of
epithelioma very fully, but already I have shown you many interesting
cases, demonstrating how it can be cured by intelligent and faithful
treatment without surgical operation. Some of you may recall the
enormous ulcerating epithelioma on the left ear of a man of about fifty,
who showed himself repeatedly after the disease had been entirely cured
by the thorium paste, which you have often seen me use. You may remember
that the upper portion of the pinna was gone, but presented a thin,
delicate cicatricial surface, freely movable; the last time he was here
was fully two years after it had been entirely well.