CASE I.—Early in 1899, Mrs. H. B., age forty-nine, presented herself
for an opinion as to her condition. She had been hoarse for three or
four weeks, and had a little inconvenience in swallowing, with no
cough, but she complained of ordinary sore throat such as would
follow an everyday cold. The main symptom was an excessive amount of
mucus from the nose, nasopharynx, and pharynx.
Examination revealed a large pharyngeal ulcer on the left side, with
enlarged cervical glands on the same side, and my suspicions were
aroused as to its malignancy. Upon expressing such a fear the
patient admitted that she had been examined by a surgeon who
likewise had suspected carcinoma and advised its removal. She
absolutely refused to think of operation at anybody’s hands, and
insisted upon my giving it the best treatment possible.
I cleansed it with the usual antiseptic solutions, and applied
orthoform and other well-known and everyday methods for a week or
two with a fair amount of relief, but the ulcer continuing, I
applied specific treatment in the hope of clearing up the diagnosis,
and, much to my delight as well as to the patient’s comfort, the
ulcer healed, the induration disappeared and the patient was, to all
intents and purposes, well. After a number of weeks the external
glands even diminished in size, so that I rather felt that the
diagnosis of cancer was wrong and that it must be specific in
character.
The patient ceased her visits, but returned in a few more weeks with
a condition as at first, but upon the opposite side of the pharynx.
Same treatment and everything else I could suggest did absolutely
nothing for her relief, and I felt that the diagnosis this time must
be carcinoma, but she refused even to have a small section taken for
the purpose of diagnosis. Consultation agreed with me as to the
malignancy of the growth, but operation was refused. She died in
another month, practically from starvation.
I report this case after having read the article by A. Worrall Palmer
upon cancer of the larynx, in the January number of this journal,
because in the prelude, this method of diagnosis, and the application of
this specific mixed treatment is advised, and because in this case it
was followed by apparently successful results with what seemed to be an
entire cure of the case, and therefore a clearing up of the diagnosis,
but which, on the other hand, was followed by a return of the same
condition, but upon the other side of the throat. The second point in
the case is the great relief of all symptoms following the iodide of
potash and merc. administered internally, and the administration of kali
bi. and arsen., which most certainly had in the early part of the
disease a very satisfactory effect. I believe that this case was cancer
from the first, but that, contrary to expectations, it yielded
beautifully to internal treatment.
CASE II.—Mrs. M. E. C, age fifty-six, presented herself with a
sensation of swelling in the throat accompanied by stinging pain,
and with a history of from one to a dozen attacks of suffocation
each twenty-four hours, much worse at night; otherwise no soreness
of the throat or special sickness preceding these attacks, but they
have been fairly constant for a year. She had become suspicious of
the trouble being cancer, and, after having had some months of
treatment from her family physician, she was more impressed with the
fact than ever.
Examination revealed nothing in the way of foreign growth, but very
much enlarged varicose veins at the base of the tongue, with a
granular pharynx. Prognosis was favorable and the treatment as
follows:
Glycerole of iodine to the pharynx and base of tongue, following
cleansing and antiseptic solutions; galvano-cautery destroying the
largest of the blood vessels, and moschus 3x internally. A complete
cure resulted in less than thirty days; complete cessation of all
attacks, which, of course, proved the diagnosis to be other than any
malignant trouble, and, although the local treatment was probably
efficacious, I believe that much of the trouble was of a neurotic
type, incident to the climacteric, and that moschus deserves a good
deal of credit for the result.