Page images
PDF
EPUB

time, this upright, respectable, and benevolent old ma-, came to me, sought my acquaintance, encouraged me to proceed in my inquiries; told me how much the elder Heberden would have been pleased with them; and promised me every assistance in his power. And he neglected no proper opportunity of furthering my views. The very last act of his life was an attempt (it proved an abortive one) to serve me; and, as he believed, by serving me, to promote the diffusion of useful knowledge. Thus did he preserve to the last breath the principles which had guided him through life: urbanity, liberality, integrity, the love of truth, and an ardent desire to contribute toward the welfare of mankind, and diminish the mass of human misery. Such were the rules of his conduct and leading traits of his character.

I am not without obligations to other individuals, which I may here, not improperly, acknowledge. Mr. Crowther procured me more than one case of cancer. Mr. Piatt, unsolicited, did the same thing. These cases were such as might have led to useful conclusions, had the patients themselves been tractable. Dr. Latham, also, the present worthy president of the college of physicians, had the goodness to recommend to me a subject laboring under a disease of this kind; but it was too far gone to afford any chance of relief.

CASE XIII.

Remarks on Cancer, with a Case.

I Feel it proper to premise a few remarks to the case which is next to be related.

It has become less necessary for me to bring before the public many additional observations on this disease, as Mr. Abernethy has done me the justice to recommend the method of treatment I proposed to the trial of surgeons, to whose care these cases commonly devolve.* I have reason to believe that

* The following is taken from Mr. Abernethy's Surgical Observations on Tumors, p 93: "There can be no subject which I think more likely to interest the mind of a surgeon than that of an endeavor to amend and alter the state of a cancerous constitution. The best timed and best conducted operation brings with it nothing but disgrace, if the diseased propensities of the constitution are active and powerful. It is after an operation that, in my opinion, we are most particularly incited to regulate k has heen tried, utder the inspection of competent judges, and therefore of this, as of every other proposal, time will ultimately decide the merits. At present, however, with regard to the experience of others I am very imperfectly informed.

I do not wish to conceal, that the testimony which Mr. Abernethv gave to the accuracy of my statements (as far as he was concerned) was given at my own request. For it is a fact, that Mr. Abernethy was so struck with the effect of the distilled water, in the case of cancer that he put into my hands, that he made upon it this pointed and remarkable declaration: "I cannot be insensible," he said, "to the effect of this treatment. Whether it will cure the disease or not, I cannot tell; but I can have no doubt but that it will prevent it."

the coostrmtion, lest the disease should be revived or renewed bj its disturbance. In addition to that attention to tranquillize and invigorate the nerroas system, and keep the digestive organs in as healthy a state as possible, which I have recommended in the first volume. I believe general experience sanctions the recommendation of a more vegetable, because lees stimulating, diet, with the addition of so much milk, broth, aud eggs as seem necessary to prevent any declension of the patient's strength.

- Very recently. Dr. Lambe has proposed a method of treating cancerous disease*, which is wholly dietetic. He recommends the adoption of a strict vegetable regimen, to avoid the use of fermented liquors, and to substitute water, purified by distillation, in the place of common water used as a beverage, and in all articles of diet in which common water is used, as tea. soups, etc. The grounds upon which he founds his opinion of the propriety of this advice, and the prospects of benefit which it holds out- may be seen iu his * Reports on Cancer,' to which I refer my readers.

"My own experience on the effects of this regimen is of course very irmited. nor does it authorize me to speak decidedly on the subject. But I think it right to observe, that in one case of carcinomatous ulceration in which it was used, the symptoms of the disease were, iu my opinion, rendered more mild, the erysipelatous inflammation, surrounding the ulcer, was removed, aud the lite of the patient was. in my judgment, considerably prolonged. The more minute details of the fact constitute the sixth case of Dr. Lambe's Reports.

"It seems to me very proper and desirable that the powers of the regimen recommended by Dr. Lambe should be fairly tried, for the following reasons:

*' 1st- Because I know some persons who, while confined to such diet, haw enjoyed very good health; and 1 have further kuown several persons, who did try the effects of such a regimen, declare that it was productive of considerable benefit. They were not indeed affected with cancer, but they were induced to adopt a change of diet to allay a state of nervous irritation, aud correct disorders of the digestive organs, upon which medicine had but little influence.

"-dly. Because it appears certain, that in general the body can be perfectly uourished by vegetables.

"3uly. It seems sufficiently ascertained, that diseases have in some persons beeu excited by water, and therefore it is desirable that whatever is used should be made as pure as possible.

'- 4thtv. Because all great changes of constitution are more likely to be effected by alterations of diet aud modes of life than by medicine.

•' othly. Because it holds out a source of hope and consolation to the patient, iu a disease where medicine is known to be unavailing, and surgery affords no more than a temporary relief."

Mr. Abernethy, in consequence of what he saw, ordered the distilled water, at this time, in some other cases. One was a case of cancer of the rectum. It was a desperate case, in the very last stage of the disease; and the patient soon died. But the sufferer declared that it gave him much ease, and that it was the only thing from which he had appeared to receive benefit. This declaration, or something tantamount to it, Mr. Abernethy told me, with the addition, "that he should at all times be willing to acknowledge it."

This leads me to mention the circumstances, which induced me to be more sanguine with regard to the hoped-for result of cases, that were very far gone, than was justifiable by the event. I do this the more willingly, in order to guard others against a similar sort of deception, which will certainly occur again, under the same circumstances. What I allude to is as follows:

In cases where the vital powers are greatly reduced, the evident change induced by a change of regimen, and the apparent advantage of such a change, is incalculably greater than where the vital powers are more perfect, and where, consequently, the immediate danger of the patient is much less. This fact has appeared in a great variety of examples. I will cite a few that were remarkable.

In a case of carcinoma of the mamma, a middle-aged woman adopted the regimen; and the consequence was, that the pain, which had been constant and severe for many months, was relieved, and almost removed in one fortnight. Such a circumstance could not but cause great delight, and excite hopes that much good might be done in a short time. But these hopes proved fallacious. The woman died in less than six months; being cut off, as I judged from correspondence, by a peripneumonic affection. •

Another woman, laboring under ancites, received great, and almost instantaneous, benefit from the regimen. The abdomen began quickly to diminish in bulk, and for more than three months she appeared to improve in health daily. But then the benefit ceased, new symptoms supervened, and in less than another month she died.

A little boy of about four years of age, who was epileptic, was made to try the same plan of diet. The effect was highly pleasing, and even astonishing. After the course of a fortnight the convulsions wholly ceased; and the head, over which he had appeared to have lost the power, became in a great measure upright. But he continued very stupid, with the sensibility so much impaired, that he seemed scarcely to be impressed oven by fire applied to the skin. In about two or three months the lower limbs became dropsical, the strength failed, and the child soon died.

These, and several other similar events, have instructed us how litUe dependence is to be placed on the first changes, however imposing they may be; they soon showed that these sudden changes denote a great diminution of the powers of life, and would not have taken place had the powers been perfect. In fact the cases which have ultimately succeeded the best, have been those in which the least benefit has been received suddenly: and from the repeated observation of such facts, I aw wow much hotter contented to be told, in a bad case, that TiitJe <\r no relief has been received, it may be, in several months, th*s the oontrarv.

I have no doubt that the observation which caused the acknowle&sywenl, which Mr. Abernethy made to me, was similar to those 1 have just mentioned. These declarations were made in the year IS05: and I was therefore not precipitate in exr•\-iing thats when Mr. Abernethy was publishing on the subie.-t wf cmccr in IS 11. ho should take the opportunity of acVn^wWging Uwtt m the statement of facts to which he had r«ee* * witsess I had been scrupulously observant of the truth. 1* thai interval, the defect of the original proposal had been 'AotecteA, Mtd sufficient time had elapsed to have tried the y<o<«w v*" the regimen, and to have ascertained in a good measaure wkat w wvuM really effect.

V>« ti»c<sgw the recommendation which Mr. Abernethy gave w*s *t 3*v sagsijesoon and request, he alone is answerable for <W tKwi W* - hick it was given. In particular, when he says, v' 5* *s as^er an eperatie* that we are more particularly incited *c w^*Wc the eenstimuou," it is what I can by no means as«-o< V,\ r>ri n>•vre Wf this presently.

Mv AVernethy says also on this subject: "I believe general *\^*iw*o* JdtK'ft.ws the recommendation of a more vegetable, ^vawsc Vs* stimnlaung diet, with the addition of so much milk, >*\s<V **A e$£* ** seen* necessary to prevent any declension ','* <W wa^cnt'V' strength." On such a subject, Mr. Abernethy is, ,v ,v»^>.\\ *»rv-h hotter informed than myself. But he certainly »#W* OMfrmwul rw* of this general experience; nor did I, dur

[ocr errors]

ing my attendance on the case which Mr. Abernethy put into my hands, receive from him the slightest hint of such an opinion. No traces of such an opinion are to be found in Mr. Abernethy's works, previously published; not even in the second edition of his treatise "On the Constitutional Origin and Treatment of Local Diseases," published in 1809, when he had seen the progress of the case we attended.

Nor was a diet of this kind recommended generally in cases of cancer even by Mr. Abernethy himself, previous to the publication of my "Reports." In proof of this I can say, the lady whom we attended was eating animal food, commonly twice a day, under the mistaken notion of supporting the strength, before it was resolved, at my suggestion, to change her diet in February, 1806. This was under Mr. Abernethy's own eye. I do not say it was done by his advice. He, I believe, never inquired into, nor gave any directions on the subject. I will further say that, had it not been for my strenuous application, this recommendation would not have been given, even in the place in which it has appeared.

I do not doubt, however, that it is the practice of the best surgeons to order a mild diet in these diseases. I have already cited the authority of Mr. Benjamin Bell to this point. Other writers have likewise recommended such a regimen. "We moderate," says one, "the effects of cancer in every stage by an antiphlogistic diet." Another writer says, "In the mean time, the patient should live abstemiously, avoiding animal food, wines, spirits, and fermented liquors, as heating, stimulating, and tending to increase pain; a milk and vegetable diet, therefore, in such cases, is the most proper." In a passage of Cheselden's anatomy, cited in the posthumous work of Mr. John Howard, it is said: "In desperate cases where we cannot extirpate, we find the best remedy is plentiful bleeding (which also is Nature's last resort), gentle constant evacuations by stool, and a vegetable diet." And in this work of Mr. Howard's is the following passage: "Except when a stimulus is required, in chlorosis, the diet in cases where there is a cancerous tendency cannot be too strictly cooling. If it consisted wholly of vegetables, farinaceous substances, and milk, many lives might be saved, or at least prolonged; but, on the contrary, the majority of patients in this predicament have an unnatural appetite for luxurious eating, and this exasperates the disease."

But notwithstanding this concurrence of opinion of respectable writers, I am afraid that it is not true that it is any thing

« PreviousContinue »