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soreness of the lower part of the abdomen. Under these complaints she had suffered about three years, and to so great a degree that she was hardly able to walk about, or do the work of her house.

She had been at another dispensary, and had a good deal of medical advice, without gaining any effectual relief; and, therefore, though the general state of the health did not seem very bad, I thought medicines alone would prove ineffectual. I therefore proposed the regimen to her, in addition to some demulcents, laxatives, and the regular use of glysters, to unload the lower part of the intestines, She declared herself willing to do any thing at all likely to relieve her; and she began it on the 8th of November, 1812.

From this plan she found a speedy alleviation of her sufferings. In two or three months the soreness and tumefaction of the bowels were removed, and gradually cathartic pills alone did their proper office of unloading the bowels, without the aid of injections. The most obstinate symptom was the pain and irritation in making water. But one day in October, 1813, she voided a calculus about the size of a small bean; and then this irritation ceased, and all her complaints were effectually relieved.

She, like the subject of Case XIV., appeared to become more hot and feverish from relinquishing animal food. The head became oppressed, with a sense of fullness and pain. These effects (for they cannot be thought the direct and natural effects of vegetable diet) seem to me to be analogous to the well-known fact of the pulse rising sometimes by bleeding. A degree of fever that was, as it were, latent and suppressed, becomes evident by the relinquishment of animal food. These symptoms gradually subsided.

It is said that patients laboring under diabetes become more thirsty and feverish by the use of vegetables. This may be true, and I should account for it upon the same principles; but it does not, in my apprehension, form any solid objection against their use even in this disease.

This woman had at the Christmas following a very severe attack of inflammatory fever. The bowels were tender and inflamed; and the head was affected even to the extent of delirium. But in about a fortnight it subsided, and she was restored to good health. When I last saw her, three or four months ago, she continued her regimen, and was in very good health.

The calculus was certainly only a portion of this woman's sufferings. I may observe that it has been proved very dis

tinctly that vegetable diet alone will not prevent the formation of calculus. A writer, whom I have cited more than once (Lobb, on Stone and Gout), has given a case where a person became first afflicted with calculus, who had used a vegetable diet eight years.

CASE XXIX.

Cancer of the Uterus.

10th March, 1815.-On the 16th of January, 1813, a woman became my patient at the General Dispensary, who, from her good sense and decency of manners, gave me a prospect of being able to effect what I had long had at heart: to treat a case of carcinoma, in an early stage, as I judge such a case ought to be treated, under the inspection of upright and enlightened professional men-terms, which it needs no testimony of mine to show to be applicable to the gentlemen, my colleagues, at that institution.

A. R., in the forty-third year of her age, had been afflicted for eight months with very severe pains, referred principally to the region of the uterus. The pain, she said, was darting and shooting; and though seated principally in the uterus, it was sometimes in front, at other times posterior, about the rectum. For, about the same time, she had had a discharge of a thin, fœtid, and apparently acrimonious ichor, sometimes tinged with blood. This discharge inflamed the skin of the thighs, with which it came in contact.

I took an early opportunity of making an examination of the parts. I found the os tincæ low down in the vagina; it was not much changed in form; perhaps it was a little fuller than natural. But it was very tender; a little handling gave uneasiness; and the pain, as she told me, from this cause, lasted almost the whole succeeding day.

I could not doubt that these were symptoms of cancer, an opinion in which I was confirmed by the habit and appearance of the subject. She described herself as having been long in a feeble, delicate state of health. The appetite had been very bad even for years, but had been latterly much worse. She had lost many teeth; and the gums were very lax and spongy. The countenance was pallid; the strength was somewhat impaired; the breathing bad, particularly upon

exertion, or going up stairs. Toward night the legs swelled. The pulse was one hundred.

On the 7th of April, this woman appeared before the consultation of the medical officers of the dispensary. I believe that none of these gentlemen had any doubts with regard to the nature of the case. She has, during the course of the treatment, repeatedly been examined by them. The reports, which were drawn up at each examination, I shall subjoin to my own account of the case.

With regard to the medicines that she has used, I may say here, once for all, that it has been necessary to employ opiates pretty freely, from the beginning of her treatment to the present time, both to relieve the pain and procure sleep; this last has been effected very imperfectly. Saturnine lotions have been useful to prevent the inflammation, and excoriation of the discharge. Aperients (principally sulphate of magnesia) were also at first necessary, but in a few months ceased to be requisite. She has taken also a few other medicines, occasionally, but as they had no marked influence on her complaints, I need not trouble the reader with an account of them.

She consented to give the regimen a fair trial, and entered upon it on the 10th of February, 1813.

I also advised her particularly to use as much fruit as possible. As the strength was radically impaired, I recommended her to be sparing of exercise, but rather to use considerably a horizontal posture.

For more than half a year very little ground was gained. The muscular strength diminished, and the pains continued to be very severe. But the pulse was reduced in frequency: it became habitually about eighty in the minute; the discharge became less offensive, and, apparently, less acrimonious.

In August, 1813, she had a considerable respite from pain, which continued for three weeks. But it then recurred with great severity; but still, though the paroxysms were as frequent as during the former part of the year, she found that the severity of them was upon the whole sensibly diminished. The respiration became rather stronger. With the pains, the discharge (which had been checked) returned; it was green and fœtid.

In the middle of December, the discharge nearly ceased, and the pain likewise. What she now principally complained of was an almost total want of sleep, and of appetite, with great lowness of spirits.

During the ensuing half year, the symptoms of cancer were

more completely got under. In the middle of April, 1814, the relief was very great. In June, the pain was quite gone, and the discharge was very trifling. In August she was discharged, principally at her own request, with all the symptoms of carcinoma subdued. The general state of the health, too, was considerably improved.

But in the October following, she again became a patient. The pain had returned with severity, having been brought on, apparently, by the approach of the cold weather. It was again attended with some trifling discharge. This aggravation of the disease was, however, of short continuance. In four or five weeks it was removed, and she again was restored to her habitual state of a cessation from pain, almost complete, and the discharge stopped, except, perhaps, in a quantity so small as to be hardly perceptible, and as to be no incon

venience.

The present state of this, considered as a local disease, is very nearly as has been just described. Habitually she is without pain or discharge. But she has occasional attacks, which last a few days, or a week. They are severe enough to break her rest, and give her uneasiness; but not enough to cause confinement, or to prevent her doing the work of her house. The last of these attacks was in the middle of February of the present year.

The proper symptoms of carcinoma, then, the pain and the discharge have been subdued and kept under by this treatment. The account to be given of the general state of the constitution, though not so satisfactory as the effect upon the local disease, has been still sufficiently encouraging.

In fact, the chief complaints, now for about fourteen months, have been much less regarding the original symptom of the disease than the general state of the health. Want of appetite, the sleep disturbed by tumultuous dreams, and sometimes wholly interrupted; want of breath, lowness of spirits, general debility, aching, and lassitude, have been the principal subjects of complaint. Upon the whole, however, the health has sensibly improved; so that she is, at present, considerably better than she was a twelvemonth ago.

The pulse continues calm, being commonly about eighty in the minute. The respiration is still not strong, but it has mended. The appetite remains bad. The sleep is disturbed, but upon the whole it is more calm than formerly. The muscular strength is a little improved; the spirits are better; there is more cheerfulness and animation in the countenance.

I think it right to add that, except from the use of opium, what she has found the greatest benefit and comfort from has been the unrestricted use of fruit and recent vegetables, as radishes, etc. When she has been able to use any other sustenance, the stomach would receive willingly something of this nature; and at night, when the tongue and fauces were dry and clammy, chewing some fruit was found to be the most certain and pleasant resource.

When we consider the deplorable, and hitherto desperate nature of this disease, that when affecting the internal organs, it must be deemed a more advanced stage of the complaint than a state of scirrhus in an external gland, this account will, I hope, be deemed as satisfactory as can be reasonably expected. The conclusions to be drawn from the facts stated are the very same as those which flowed from those related under Case XIII. of this work. If I therefore repeat them, I trust that the importance of the subject will be deemed a sufficient apology. It follows then from this statement

1st. That this disease was evidently carcinoma. Its history, at the first examination, made this sufficiently evident.

2d. That the disease continues to be carcinoma at this time. The same symptoms which at the beginning authorized us to give it this designation, still recur, but with a much inferior degree of severity. The effect of the treatment then has not been, strictly speaking, to cure the disease, but to control and mitigate the symptoms.

3d. But by the regimen, life itself has been preserved. It will not be disputed, I suppose, that even a twelvemonth is as much as, under the common habits of life, a case of uterine cancer might be expected to last. Two years must be, indisputably, beyond all probability. But five-and-twenty months have now elapsed, and the patient is not only alive, but in a state of improved health.

4th. The disease has made no local progress. On the contrary, the symptoms have been all soothed and tranquilized. 5th. The ulcerative process has been wholly superseded. 6th. I may add that the facts of this case may be applied to the treatment of dropsy as well as to that of the cancer. There was, when she first became a patient of the dispensary, some anasarcous swelling of the iegs, as I have noted. This continued nearly in the same state for the first year, or year and a half. It is now nearly, if not entirely gone. The flow of urine has throughout continued very copious.

I need hardly say how much encouragement the result of

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