certain Knowledge of the Principles of the Juice which is lodged in the
Cancerous Substance, although it enjoyed the very same Properties, of
that which is discharged from an ulcerated _Cancer_, from the Account
which Authors have given of the latter; for they have differed very
much in determining the Nature of the Salts, with which they suppose
it abounds. _Helmont_, _Van Horne_, and most of those Gentlemen that
were Chymically inclined, were of Opinion they belonged to the Alkaline
Family, but a far greater Number than those, have thought they are
Acid. _Riolan_, the Father, in his Chirurgical Works, without giving
his Opinion what the constituent Parts of the purulent Matter are,
affirmed it to be as strong as Poison, and that no Death could be
devised too cruel for such a One as should give it to a Man. This
brings to my Remembrance a very unhappy Accident a Gentleman informed
me of that befel Mr _Smith_, one of the _Surgeons_ of St _Thomas_’s
_Hospital_, who being so curious as to taste the Juice of a cancerated
Breast presently after it was extirpated, found himself very strangely
affected by it, in a very short Time; he washed his Mouth with various
Things, but nothing could free him from that penetrating, malignant,
and nauseous Savour, he was continually attended with; in short, he
became consumptive, and in a few Months died a Martyr to the Art of
_Surgery_. I confess when I received this Account it did not a little
surprize me, because I had several times had the Curiosity to do the
very same Thing, at the _Hospital_ where that unfortunate Genman made
the Experiment. I never found any remarkable Sharpness in it, though it
was always attended with a very unpleasant Savour. I proceeded at first
very cautiously in making this Attempt; for I deluted some Drops of the
Juice in several Spoons-full of fair Water, till at length, not finding
any Inconvenience from it, I came to the Juice it self. We cannot
imagine the Death of that Gentleman before-mentioned, was procured
by the Action of any corrosive Salts, whether _Acid_ or _Alkaline_,
which would have caused a Corrosion of the Parts, but that it is only
accountable from the extraordinary Stench and Malignity of the Matter,
which impressing its Virulency on the Animal Juices must undoubtedly
disturb their regular Motions, and cause the utmost Confusion of the
whole Oeconomy. It must certainly be a very tragical Scene, to observe
how Nature, by so inconsiderale Means, confounds and insults, over the
Animal System; but still there is nothing we are more certain of, than
that her Method of Procedure is always consistent to the Rules she
acts by. Since the writing of this, looking over a little Tract which
informs us of the Rarities in _New-England_, I met with a Relation
which discovers to us the peculiar and odd Quality of the Juice of a
cancerated Breast, or Wolf, as our Author calls it. He tells us that an
indulgent Husband, by sucking his Wife’s sore Breast to draw out the
Poison, lost all his Teeth, but was attended by no other Inconvenience.
Now this does not prove that so strange an Effect should succeed the
sucking the Ulcer, because of the Corrosiveness of the Matter; for had
it been so, such tender Parts as the Gums, Lips, and Tongue, could not
have escaped so well as to have received no Damage by it.
Problem II.
_Whether_ Cancers _are contagious, or not._
[Sidenote: Vid. _Zacut. de Prax._ Med. admirand. _Lib._ 1. _Obs._ 15.]
There has been a very great Disagreement in the Sentiments of our
Predecessors as to this Point; but _Zacutas Lusitanus_ proposes to
prove it by Reason and Experience. His Reasons are, _First_, because
in an ulcerated _Cancer_ there is a Cadaverous Stench and Rottenness,
which infects the Neighbouring Parts with it’s Virulency. _Secondly_,
Because a _Cancer_ is the same _Disease_ as an _Elephantiasis_, and
_Leprosy_ of a particular Part. To this, _Sennertus_ in his Posthumous
Works answers, that all corrupted and fætid Substances are not
contagious; for in a _Gangrene_ and _Sphacellus_, there is the greatest
Corruption and offensive Smell, yet we do not find that a Person is
killed by it: He adds, though a _Cancer_ has some Similitude to an
_Elephantiasis_, they are different _Diseases_. _Lusitanus_ deduces
his Experience from an Observation of a poor Woman, that having an
ulcerated _Cancer_ in her Breast, and lying with three Children, they
were affected after the same Manner by the Contagion. He says that
Two of them died, but the Third, which was of a stronger [Sidenote:
_Vid_ Sennert. _Paralipom. ad Part._ 1 _Cap._ 19.] Constitution,
had the _Cancer_ cut off by a _Surgeon_ and was cured. _Sennertus_
is of Opinion that these Children did not contract the _Disease_ by
Contagion, but that it was by Hereditary Succession. We likewise find
that _Cardan_, _Lib. de Venen. Cap._ 12. is of Opinion that _Cancers_
are not contagious. However, we will not make any particular Enquiry
into these Authors Reasons, when they so strenuously maintain this
Point; but only relate a remarkable History, which will prove the
contrary, if the _Cancerous_ Matter comes to an immediate Contract with
a soft and glandulous Part. The Relation I had (some time ago) from a
Gentleman not long since deceased, who, out of a pious Disposition,
had devoted himself for several Years last past, to be serviceable to
the greatest Objects of Charity. He informed me that a Tradesman’s
Wife in _Nottingham_, being so unhappy as to labour under a _Cancer_
in one of her Breasts, her Husband was of Opinion he could relieve
her by sucking it; accordingly he put this Method in Practice, in
hopes without doubt he could effect a Cure, by drawing the _Cancerous_
Matter out of the Nipple; he continued his Attempts for some Time,
but found it did not answer his Design; for though a small Quantity
of Matter was discharged [Sidenote: _Vide_ Galen. _in_ Aph. Hip.
Com. Lib. 6 Aph. 38.] this way, the _Disease_ still became worse, and
she terminated her Life soon after. Two Months were scarce expired
before the Husband of the Deceased came up to _London_, upon Account
of a swelling he had arose on the Inside of the upper Jaw; he applied
himself to some ingenious _Surgeons_ for Advice, who assured him he
must undergo the drawing of Several Teeth on that Side of the Jaw
which was affected, and have the Swelling, and Part of the Jaw-Bone
(if necessary) cut away; he went away very much disatisfyed with so
harsh a Proposal, and became a Patient to a Person, who undertook to
cure him with _Gargels_, and such inconsiderable Remedies; however, by
the Use of these Things he was of Opinion he became much better, and
thought he should be cured. Upon this he retired into the Country to
his Business, but in less than a Month’s Time he was obliged to come up
again, and have the former Method put in Practice. But the Event was
according to that Expression of _Galen_, _Quibus item sunt Cancri in
cavitate Corporis, aut Palato, sede utero, si secentur, aut urantur,
ulcera cicatrice induci non possunt_. For the Sore could never be
brought to cicatrize, but the _Cancer_ continu’d to spread, till it
had extended in self over most of the internal Parts of the Mouth,
and to the inner Part of the Nose: In this unhappy Condition, he lived
some time, but at last became so frightful an Object, and the Stench
that continually proceeded from the Parts was so offensive, that he
retired himself from the World, and finished his miserable Life in a
Garret. Since the finishing the _Solution_ to the foregoing _Problem_,
I met with a Surgeon (a Foreigner) who giving me an Account of the
present State of the Practice of _Surgery_ in the Country where he
lived, and relating some considerable Cases which had happened within
his own Knowledge, in answer to my Desire, among other things, told
me, without any particular Intimation from me, he knew a very odd
Accident, which happened upon a Woman’s having an ulcerated _Cancer_
in her right Breast, which was, that she being poor, for want of other
Conveniences, suffered two Children she had to lie with her in that
Condition; at length one of them, a Girl about five Years old, began
to be afflicted with a small painful Tumour in one of her Breasts,
which encreasing to near the Bigness of an Egg, became Livid, and
entirely _Cancerous_; the Mother died some time after, and the Child
did not long survive her; but the other Child continued well. Several
Surgeons gave their Sentiments of this Case; some thought it to
be an Hereditary Indisposition; but considering the Mother had no
Appearance of a _Cancer_ before or at the Birth of the Child, I cannot
but readily embrace the Opinion of those Gentlemen, that were inclined
to believe that it was contracted by Contagion, seeing the Position
of the Child’s Body was such in Bed, that that Part of it which was
affected was almost always disposed to rub against the Dressings soaked
in Matter, (for I understand the Mother took but very little Care to
change them often.) Now it is not at all probable, that the malignant
_Effluvia_, which continually pass off from the _Cancerous Mass_, and
the putrefied Matter, can dispose a Person at any little Distance to
be affected with the like _Disease_, for then the other Child would
have became a Sufferer; but it may happen in some extraordinary Cases,
where the corrupted Fluid has attained an exalted Pitch of Malignity,
to communicate some of its more active Particles to the Blood and
Spirit; and so causing a very great Disorder in their Motions produce a
violent Fever, and Confusion of the whole Oeconomy, so as to occasion
a Person’s Death. But see a remarkable Case in _Tulpius_, _Lib._ 4.
_Obs._ 8. 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; for then, without doubt, it may contuminate
the Fluids, and incline them to assume a Viscidity, to which the
_Effluvia_ will immediately adhere, because they are best qualifyed for
a Union with those Substances that are viscous. To this we may add,
that in those Persons that are nearly related, the Malignity may be
more easily communicable because of their Analogy to each other; for
consonant hereto, _Diemerbroeck_ says in his Treatise of _the Plague_,
that _Kindred more easily receive the Infection from one another_. But
see more in that Author’s excellent Book where you have likewise some
curious Thoughts relating to Contagion. [Sidenote: Vide _Diemerbroeck_
de _Pest_. Page 58.]
PROBLEM III.
_Whether if the extirpating a_ Cancerous Breast _happens to be
successful, it ought to be look’d upon as a Consequence of Performing
the Operation better than our Predecessors._
[Sidenote: Vide _Ætius Tetrab._ 4. Ser. 4. _Cap._ 44.] By the Account
we receive from Authors we cannot be positively assured, whether there
was any particular established Method in the first Ages of this Art,
for the Performance of this Operation: This we are only assured of
that there are some Circumstances which relate to it, that have been
taken Notice of; the most considerable of which is, that the actual
Cautery was to be applied immediately after the Abscision; this they
advised, not only to put a Stop to the Flux of Blood, but likewise
to correct the ill Quality of it: It is to be observed, that they
ordered always, upon such an Occasion, Defensatives to be applied
to the contiguous Parts, to prevent their being inflamed; but for
as much as they were sensible the actual Cautery would procure an
Eschar, they recommended the Use of Digestives to separate it; after
which, they proposed to heal it as [Sidenote: Vide _Arceus_, lib. 2.
Cap 3. de _Curand. Vulnerib._] a common Ulcer. The very next Advance
this Operation received, that we have met with, was by that Accurate
Writer _Franciscus Arceus_, who obliged the World with an exact and
methodical Account of the whole Method of Procedure in extirpating
a _Cancer_ in the Breast; though this Author would only venture on
those that were not Ulcerated, those that were he looked upon as
incurable. We do not find that this Method was recommended to the
World by any remarkable Histories of Cures effected by it; whether it
proceeded from the Unsuccessfulness of the Attempts, or its Disuse, we
cannot determine. _Fabritius Hildanus_ likewise made a considerable
Step towards the Encouraging the Performing this Operation; and he
assures us, he has more than once done it with Success; he did not
only influence his Cotemporaries to revive an Operation, that was,
perhaps, almost grown out of Date, by the Histories of some Cases he
recites; but obliged them with the Figure of a Pair of Forceps, which
in this Operation are very convenient to engage the Breast, and thereby
prevent the Pain the Patients are sometimes put to, by piercing the
Breast with Needles armed with Silk to suspend it. There are several
Ways of performing the Operation, mentioned by later Practitioners,
but at this Time there are few that are willing to be concerned in
it. A very considerable Author speaking of extirpating a _Cancerous
Breast_, advises us to take care we do not cut the Pectoral Muscle in
the Operation: But we have seen a very remarkable Case of this Nature,
where a Part of that Muscle was cut away, and the Cartilages of the
two of the Ribs laid bare, and the Patient happened to be cured.
Now if our Predecessors had so great a Respect to the avoiding the
wounding of this Part, as to make their Incisions too superficial,
their Operations must be in all Probability unsuccessful; for we are
very well assured by Experience, that their actual Cauteries will have
no good Effect here, nor will they consume the remaining Part of the
_Cancerous Mass_. We have elsewhere shewed, that this Substance upon
boiling becomes hard and friable; and we will here take the Liberty to
give our Opinion of the Use of Cauteries in this Case. The _Cancerous
Substance_ we take to be nothing more than a Transformation of the
small glandulous Bodies, which form the Breast, and a Lymphatick Juice,
intimately incorporated therewith, into a hard, close, whitish, and
(by common Medicines) indissolvable _Mass_. In some Cases, perhaps, it
may receive some Addition from some Juices, which may distil from the
contiguous Fibres. This being granted, what Benefit, can we reasonably
imagine, will ensue on this painful Method? Will not the Fire, by
causing the more Fluid Parts of the _Mass_ to evaporate, actually dry
up, torrefy, and harden it; and so dispose it for displaying a Train
of mischievous Effects, on the contiguous Parts? and all this without
any very apparent Decrease of it too: Nay, the very reducing of it to
such a Consistence, which very much resembles a Piece of burnt Horn,
is sufficient to procure a perpetual Pain, seeing Medicines can hardly
soften it, so as to reduce it to its first State.
PROBLEM IV.
_Whether_ Salivation _will Cure a_ Cancer.
The extraordinary Success this Method has been attended with, in some
Cases of the greatest Difficulty, has so far recommended it to the
World, that it is at this Time become of so great Repute, that there
are few Persons but what will willingly embrace it, if proposed to
them, provided they have found former Methods prove ineffectual. We
once knew a Person, who laboured under an ulcerated _Cancer_ in her
Breast, advised to it, and who had certainly under-gone it, though
contrary to the Opinion of some Persons concerned, if in three or four
Days time she had not been reduced to such a weak Condition, that it
put an End to the Controversy. That a _Salivation_ has cured the most
malign and spreading Ulcers, and those that have been of several Years
continuance, notwithstanding their Edges have been high, inverted and
assumed the Consistence of a callous Body, we have found by several
Instances; but that it should cure a _Cancerous Ulcer_, an _Ulcer_
which is chiefly seated in a transformed animal Substance, and which
has no Correspondence with the contiguous Parts, is what we cannot
believe. One of the principal Effects of _Mercury_, if prudently given,
is, that it attenuates the Juices, clears the Canals, destroys the
ill Quality of that Fluid that has a Hand in causing any Obstruction,
and renders the Juices temperate and sweet. By effecting this, it is,
that it cures so many different Diseases, which perhaps have not so
great a Diversity in their Causes, but have different Appearances,
which depend upon the Variety of Parts, where the Cause operates.
From hence any One may judge, that a Person who discovers a certain
Method of curing _Cancers_ by Medicines only, will find that it will
not consist in a Secret for purifying the Juices, which can have no
Effect on the _Cancerous Mass_, so as to procure it’s Dissolution; and
without a Remedy for which his Method will be always unsuccessful.
_Mercklin_, in his Treatise _de Transfus Sanguinis_, page 35, tells us
we have no Reason to believe we may have Success from Transfusion in a
_Cancer_, nor indeed would Injections succeed better; though, perhaps,
by this Means, it is possible so to alter the Fluids, that _Ulcers_,
not _Cancerous_, may be cured in a short Time, as it once happened
to a certain Person, who being under Cure for an inveterate Pox, had
some _Rosin_ of _Scammony_ infused in the Essence of _Guaiacum_,
injected into his Veins, which Vomited him excessively; but his
_Ulcers_ were healed in three Days Time. From what has been hitherto
said, it is evident, that a _Salivation_ can never cure a confirmed
_Cancer_, because it is not capable of procuring a Dissolution of that
hard Substance, which is the real _Cancer_ it self. The Glands we
have observed, with the extravasated _Lympha_, and its Vessels, are
perfectly changed to a different Substance to what they were before,
all which make a _Mass_ of such a Nature, that it will be impossible
to procure it’s Dissolution by any inward Means. If the _Cancer_ was
nothing more than a Coagulation of the Juices in the Vessels, or other
Canals, or Pipes, the Cure might be much more easily effected, but as
the _Cancer_ is conjoined with such Circumstances as we have mentioned,
we may affirm the Cure will be altogether impossible without the whole
Substance with it’s Appendices or Branches (which we have found they
often have) be taken away; or a perfect Dissolution of all of it be
procured by some external Remedy, which is capable of operating on it
after such a peculiar Manner, as to dissolve the _Cancerous Substance_,
without having any such Effect on the contiguous Parts.
PROBLEM V.
_Whether Cancers are Curable by Causticks._