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 even 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 little 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 am now much better contented to be told, in a bad case, that Ettle or no relief has been received, it may be, in several months, than the contrary.

1 have no doubt that the observation which caused the acknowledgment, which Mr. Abernethy made to me, was similar to those I have just mentioned. These declarations were made in the year 1805; and I was therefore not precipitate in expecting that, when Mr. Abernethy was publishing on the subSect of cancer in 1811, he should take the opportunity of acknowledging that in the statement of facts to which he had been a witness I had been scrupulously observant of the truth. In that interval, the defect of the original proposal had been detected, and sufficient time had elapsed to have tried the power of the regimen, and to have ascertained in a good measay what it would really effect.

Fat though the recommendation which Mr. Abernethy gave ***.*** sggestion and request, he alone is answerable for the tems in which it was given. In particular, when he says, * a scher an operation that we are more particularly incited * mulce the constitution," it is what I can by no means asBut more of this presently.

M- Abesar smys also on this subject: “I believe general PLAYBY KENTions the recommendation of a more vegetable, Avisos os sumulating diet, with the addition of so much milk, And as nga as seem necessary to prevent any declension at the acron's saveth." On such a subject, Mr. Abernethy is, aytenu mand beater informed than myself. But he certainly aya stared me of this general experience; nor did I, dur

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.

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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. 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

like the common practice of surgeons in general to recommend even such a diet, as Mr. Abernethy has said is "sanctioned by general experience." I could, if necessary, bring the direct proof of the contrary, but I am restrained from motives which are very obvious.

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Nor indeed is this wonderful, when we consider how trifling is the relief which such a diet can be thought to afford. It is very doubtful whether it would give any relief to the pain which forms so distressing a feature of the disease. It is quite certain that the strictest vegetable regimen, unaided by ther attention, will not prevent the formation of a carcinomatous tumor, nor its regular progressive increase, nor its final ulceration. It is not surprising, then, that patients should be unwilling to submit to restraints which appear to them to produce little or no advantage. That the disease goes through its stages in the usual manner, while the patient is confined to vegetables, may be safely inferred from the silence of writers who, had the contrary been the case, could not have failed to inform us of it.

Indeed, I have myself had ocular proof of the fact. In the spring of 1810, I saw Mrs. M—, the wife of a tradesman living near Westminster Bridge, laboring under a large ulcerated cancer, with the breath much oppressed, as is usual in the last stages of the disease. This woman had lived almost entirely upon vegetable diet her whole life. She had an aversion to animal food. She would take a little fish sometimes, but very rarely. Her own account was to the following purport. "When I lived in the country, I was very healthy; but as soon as I began to drink the Thames water my health began to fail, and I have not been in good health since." I am obliged to Dr. Richard Reece, for introducing me to this patient, and he saw her with me. I think it right to add, in favor of her vegetable regimen, that I never saw more placidness, cheerfulness, and resignation under the appearance of so much suffering.

Mr. Abernethy's luminous description of this disease leaves nothing to be desired with regard to its general history. I could have wished that he had spoken with more decision on the most important feature of the disease—the manner in which it spreads. The facts which I showed him throw much light on this point, but they require to be verified and multiplied. Mr. Abernethy cites the doctrine of Mr. Hunter, with apparent approbation : "That a disposition to cancer exists in the surrounding parts, prior to the actual occurrence of the diseased

action. This remark, which is verified by daily experience, led to the following rule in practice-That a surgeon ought not to be contented with removing merely the indurated or actually diseased part, but that he should also take away some portion of the surrounding substances, in which a diseased disposition may probably have been excited."

If the disease be propagated by contamination, a part, which is tainted, communicating disease to the parts in contact with it, this practice must be injudicious. But if the spreading of the disease be from internal causes, foreign to the part itself, it is equally clear that this removal of the parts, to whatever extent it be carried, cannot prevent the recurrence of the disease. Let us attend then to the evidence of a most impartial and upright observer, who has left us among others the following history.

"A lady, between fifty and sixty, the wife of a surgeon, of a melancholic temperament, lusty, using little exercise, and living luxuriously, felt pain, and perceived a small degree of hardness in one breast. The whole breast was taken off, within a fortnight after it was first noticed. Upon examination after removal, there was neither extravasation nor glandular induration, but a thickening and a hardness of what seemed to be more like condensed diseased cellular membrane than any thing else to which I could compare it. The axillary glands were not affected, nor was the tumor of great size, and it was perfectly movable.

"If, in this case, the indurated part only had been removed, without taking away the whole of the mamma, I should not have wondered at a relapse; but when the operator went clearly beyond the apparent extent of the disease in every directionwhen he dissected the whole from the pectoral muscle, so as to leave the fibres of that muscle bare, and that too at an early period of the disease-I say, when all these circumstances were considered, it was matter of astonishment to me that the unfortunate sufferer did not obtain a cure. But the fact was otherwise."

This is not a solitary example. In the same work in which the writer appears to have recorded the experience of his life, are nine or ten other cases, in which the disease repullulated after operations. This circumstance is inexplicable on the hypothesis of the unsound parts contaminating the sound. But they occasion no difficulty, if we suppose (as I have done) the progress of the disease to be from internal causes. Is it not indeed revolting to common sense to suppose that cutting off

the breast can counteract the effect of luxurious living? This would be truly a matter of astonishment.

This fact is of itself enough to make us doubt whether this disease be propagated by contamination, which is the most common doctrine of surgeons. The belief in this doctrine it is which makes them so anxious to remove every particle of a diseased breast, in which any degree of hardness is perceptible. And the almost uniform failure of the operation was, for a time, often attributed to a defect in this respect. I suppose, however, that, at present, very few are disposed to maintain this opinion.

On the mode in which the disease is propagated there may be three distinct hypotheses proposed. 1st. It may be supposed that there is a poison generated in the part, which, being absorbed, infects the constitution. This may be true in part, but cannot be so entirely; for in that case excision would be a radical cure. 2d. The diseased part may be thought to injure the neighboring parts by simple contact, the diseased part being a sort of focus or centre of diseased action. This is certainly the prevailing opinion of surgeons; but it is as little tenable as the first hypothesis. 3d. All the phenomena may be thought to be the effect of internal causes, remote from the part itself, and common to this with other chronic diseases. If this be true, these causes, being common causes, there can be no specific poison of cancer. And such I conceive to be the truth, and to afford a just explanation of the symptoms of the disease. I must leave the proofs of it to the judgment of others.

We are constantly deluded by language. We say a person dies of a cancer; which is just as true as when we say that the sun rises in the east and sets in the west. The truth must be that a person dies of the causes of cancer; and the cancer is not the cause, but the mode of dying.

Mr. Howard has, in so many words, maintained the same doctrine as myself, that there is no specific poison of cancer. He says, "If the cause of some cancers be a virus, I suspect it is not, strictly speaking, sui generis, as the small-pox, but an affection of the elephantiasis kind."

But I not only coincide with the doctrine of Mr. Hunter, that there is a morbid change in the parts in which there is no manifest change of structure, but contend that this change is the very essence of the disease; and that upon this, as upon a foundation, the whole superstructure of morbid action is built. I have already cited in favor of this doctrine, the phenomenon in