Chapter III: Introduction: To the (2)

I look upon it as a peculiar Happiness, to live in an Age when Men of our Profession consider, that as the Art is capable of receiving daily Improvements; useful Discoveries, confirmed by Experiments, ought to receive the joint Concurrence of their good Wishes; notwithstanding, they may contradict an Opinion that has been almost universally received. These we shall always find, are the Gentlemen who in opposition to those Bigots whose Tempers discover them to be the Votaries of a few opinionative Men, endeavour to guide their Judgments by Reason, backed with judicious Observations, and whatever Arguments are produced, will never go about to controul Matters of Fact. It is a grand Truth that Necessity gave Being to _Physick_ and _Surgery_, and Experience is the only Way to bring them to Perfection; but it is much to be lamented by them that are Well-Wishers to those Arts that the Persons which are perhaps capable of advancing them most, devote themselves so much to speculative Fictions (the Effects of teeming Brains) that some have pretended with a magisterial Air to dictate, even to Experience itself. In such a Case it would be needless to go about to offer Arguments sufficient to disengage their Inclinations, Time only must discover to them their Error, when it makes them sensible they have, to no Purpose, persisted in the Pursuit of frivolous Niceties; for in reality, the Benefit of Mankind in general is deduced from Practical Truths. The Thoughts of this are sufficient to inspire every generous Soul with an ardent Desire of discovering something that may be of so universal an Advantage: As for my own Part, I was not animated to concern my self in the Undertaking I have engaged in, by a Prospect of gaining that Honour that is often liberally bestowed on those that mint new _Hypotheses_, or make new Discoveries; my only Design was to inform my self, whether some of those Diseases, which are generally reputed incureable, are not actually in themselves curable, and by this means to wipe off a Reproach which has been cast on Nature, when in reality it proceeds only from our own Weakness, and the Infirmity of our Art. A diligent Application to those Distempers which baffle us most, has been frequently recommended by very reputable Authors, and some of those who have obliged us with the Histories of _Diseased Persons_, have very often mentioned considerable Cures, which have been happily performed after the Patients have been looked upon by some as incurable. _Hippocrates_ tells us, _Lib._ 2 _Aph._ 52. _Si Medico secundum rectam Rationem Facienti, Curatio non statim succedat, non est tamen mutanda Methodus, quamdiu id restat quod à Principio visum est._ I am fully persuaded that most Practitioners in _Surgery_ have at some Time or other, by an industrious Application, been successfull where Art could not warrant a Cure. As to the _Disease_ I propose to make the chief Subject of this Letter, tho’ it be generally branded with the Character of Incurable, I must freely own I never could discover any thing essential to it in general that should make it so; it is true, there are many _Diseases_ that are not to be cured, where certain Circumstances are conjoined, which very much contribute to the Misfortune; tho’ Others of the same _Class_ exempt from those Adherents may, perhaps, be happily enough cured; Thus for Instance. In _Cancers_ we have but little Reason to expect a Cure in a Person that is old, if the _Cancer_ has been of many Years standing, and is firmly fixed to the Ribs; but if the Patient be not so far advanced in Years as to be uncapable of receiving the Benefit of Nature by the regular Discharge of the _Menses_ and the _Cancer_ be loose; notwithstanding, it be Ulcerated, over-spread with fungous Flesh, discharge a filthy Matter, and smell very offensively; we do upon Experience affirm that such a Patient may be cured. We must own we cannot be of the Opinion of the _Paracelsians_, who affirm there is no _Disease_ but what is curable in any Patient, for the Reason we have given; nor can we with the _Galenists_, agree that the _Gout_, _Dead-palsie_, _Stone_, _Cancer_, &c. are _Diseases_ absolutely incurable; because Experience discovers the contrary. We find that Mr _Boyle_ is of the same Opinion, and thinks it were no ill Piece of Service to Mankind, if a severe Collection were made of the Cures of such Persons as have been judged irrecoverable by the _Doctors_; that Men might no longer excuse their own Ignorance by the Impotency of Nature, and bare the World in Hand, as if the Art of _Physick_ and their Skill, were of the same Extent. There seems to be one very effectual Way to rescue the medicinal Art from the Aspersions of some bold Persons; and that is that of a certain Number of regular Practitioners in _Physick_ and _Surgery_, each of them should apply himself to the Study of one particular _Disease_: By this means we should soon find they would be capable of surmounting those Difficulties that have all along baffled the most Judicious of the general Practicers. How odd, and disagreeable this Opinion may seem to some Men I know not; but I assure you, _Sir_, I find it of a very ancient Date; for _Herodotus_, a _Greek Historian_ informs us, that before his Time, the _Physicians_ in _Egypt_ used to apply themselves to the Study and Advancement of one _Disease_ in particular. _Baricellus_, and _Lionardo di Capoa_, observe the same likewise, in Relation to the Practice of _Physick_ in that Country. _Baglivi_, in the Scheme he lays down for erecting of Colleges for the Improvement of _Physick_, tells us, that every Fellow of his Literate Society must have one _Disease_ allotted him for the Task of his whole Life; and which elsewhere he says is not sufficient for the illustrating the Province of one _Disease_; but that we lie under a Necessity of taking in Materials from all Hands. But there is no Man that we know of, has spoke more agreeably of this Matter than Dr _Harris_, in his _Pharmacologia Anti-Empirica_, he owns that he took more than ordinary Pains in one particular _Disease_, and assures us he verily believes if learned Men, after a compleat Acquisition of the universal Method of _Physick_, and a necessary Search into the Nature and Cures of those manifold Infirmities and Diseases, which, with a kind of infinite Variety, do afflict Mankind, would, with their utmost Vigour and Resolution, prosecute the Knowledge of some one _Disease_ eminently above others; they would, most certainly, find a particular Providence attending and assisting them in so good and honest a Design. He adds, a few Pages farther, that wherever a Man’s Thoughts are intent and fixed, wherever his Genius does naturally incline, and all his Aims and Application do continually tend, whether it be to pertinent or insignificant Matters; whether it be to useful, or else meerly curious Things; if he has but tolerable Parts, and Education corresponding, he can hardly ever miss; it is hardly possible he should miss the becoming Eminent, and in great Measure perfect, (I mean perfect (says he) according to the Modulum of Human Capacity) in that one Point. But there is one Thing to be recommended to the Consideration of the Person, who takes upon him the Enquiry into the Nature of one particular _Disease_, which perhaps he might be very liable to err in, if not cautioned against; and that is, that he be not too bold and rash in his Attempts; for, as _Galen_ says, _The_ Physician’s _Art is not like that of an_ Artificer, _who may make what Experiments he pleases, to satisfy his Curiosity; because if he spoils the Materials he works on, no Body is endangered by the Miscarriage: In Corpore autem humane_ (adds he) _ea tentare quæ non sunt Experientium comprobata Periculo non vacat, cum temerariæ Experientiæ Finis sit totius Animantis internecio_. I believe we shall find that one of the grand Reasons, why Persons, generally speaking, have been so negligent in making any Attempts on _Cancers_, has been the seeming Discouragement they have all along met with from Authors. The Caution _Hypocrates_ has given us in his Thirty eighth _Aphor. Sect._ 6. has scarce been omitted by any one considerable Person that has wrote of this Subject, tho’ perhaps the Sentence has often had an Exposition put upon it, contrary to the Author’s Meaning; but of this, more in it’s proper Place. I proceed now to give an Idea of _Cancers_ in the Breast from an external Cause; and this I shall do without concerning my self with the Opinion of the Ancients; for since we have been so happy as to live in an Age which will be remarkable for the many surprising Discoveries which have been made in _Anatomy_: We should be reckoned unworthy the Advantages we enjoy, if we did not study to apply them to the Benefit of Mankind in general. The more inquisitive and learned Part of the World, are at this time very well assured that the Animal Body is an exquisitely framed Machine, and that it’s Composure is little else than a Compages of branching and winding Canals, which are kept to a moderate Degree of Extention, by Fluids of different Natures; and that the Motions of these were first determined by the divine Architect: Thus in a natural State, the whole _Fabrick_ is governed by certain Laws impressed on the Fluids; and we often find the unhappy Consequences of the Discomposure of a Part, to discover themselves first by an Interruption of the Motion of the animal Juices. Thus in a _Cancer_ of the Breast which proceeds from a Blow or Bruise (as upon strict Enquiry we have found they most commonly do) is it not probable that by such means a Confusion of the true Order of the little Glandulous Grains and their excretory Ducts may happen? and at the same time an extravasated _Lympha_ may lodge in such a spungy Texture, which in time becoming viscid, will coalesce with the Glandular Substance, and form a _Mass_ considerably compact? Now this being so, it is reasonable to believe that as the Lymphatic Juice continues its Motion till it arrives at the indurated Part, its Passage must be embarrassed there; upon which, it will soon be qualified for an Union with the remaining Part of the glandulous Substance of the Breast; and so the whole be perfectly changed from what it was before. This _Hypothesis_ is in a great Measure grounded on Experiments; for if we express a Juice from some of the _Cancerous Mass_, and hold some of it in a Spoon over a Fire, there immediately flys off a small Vapour, and the Remainder hardens not unlike the white of an Egg boiled; this shows it to have the Properties of the _Lympha_; for the Chymical _Analysis_ of that Liquor assures us it is a Composition of a great deal of fixt _Sulphur_, a little _Volatile_, some _Phlegm_, and much _Volatile Alkalie_; to which some add a little Earth: Now while the _Volatile Alkalie_ keeps the Sulphur dissolved, the _Lympha_ remains in a State of Fluidity; but when, by making the same Experiment, the _Volatile Alkalie_ is evaporated, the Remainder hardens, and forms a pretty compact, whitish Substance. From hence the judicious _SURGEON_ may easily deduce the Reason why these Sort of Tumours can never be brought to Suppuration. We shall not be so particular as to mention those _Cancers_ which proceed from internal Causes, nor several other things which relate to the former; for what we have here said, we look upon to be commonly the Method of the Formation of them; and as such, we did endeavour to calculate Remedies that should peculiarly operate on the _Mass_, so as to dis-unite the firm Cohæsion of its Parts, and dispose them to separate and come away, without any great Inconvenience to the Patient; which is what we would _recommend_ with all the Earnestness imaginable to those that are desirous of discovering a Method of curing _Cancers_. We were before sensible that it was possible for one Body to operate on another determinate Body, without being able to have any such Effect on innumerable Others; as _Quicksilver_ will desolve Gold, _Aqua-fortis_ Iron, _Vinegar_ the Shell of an Egg, _Oyl_ common Sulphur, _&c._ which will not have any such Effect on several other Bodies; for there is nothing more certain than that the Operations of Dissolvents are so determined by the various Texture of the Bodies on which they are employed, that a Liquor that is capable to corrode a more hard and solid Body, may be unable to disunite the Parts of one more soft and thin, if of a Texture indisposed to admit the small Parts of the _Menstruum_. It may be expected I should say something in relation to that which is generally looked upon to be the grand Cause of the Incurableness of _Cancers_, I mean the acid Humour in the Blood. But if those Gentlemen who are fond of entertaining this Opinion, do but consider that _Cancers_ are often formed in a perfect State of Health; and that during the Time the Cancerous Substance dissolves, and comes away according to our Method, the Sides will run a digested Matter, and heal by the Application of dry Lint only; they will be of my Opinion, that neither the _Atrabile_ of the Ancients, the corrosive _Alkalious_ Salt of the _Chymists_, nor the predominant _Acid_ of the Rest of the Moderns, are capable of procuring those Alterations that _Cancers_ are sometimes attended with. If we trace the Writings of our Predecessors to their earliest Date, we shall find that many of them have made Mention of the Roots of the _Cancer_, which they took to be the large blew Veins that are often extended on its Surface; and the entire Removal of these they thought to be absolutely necessary, or the Patient could not be cured: But I believe there is no Body at this Time that considers the _Mechanism_ of the Parts in such a Condition, but will agree they are the necessary Consequents of it, and that their Absence, or Presence is of no Importance; that the _Cancer_ is sometimes attended with Adherents, or Appendices, which may very well resemble Roots, we are assured; but these generally lay deep, and not easily discovered; the most considerable One that ever we saw was very near Five Inches long, and of an unequal Bigness, some Part of it did not exceed the Largeness of a _Goose_’s Quill, but some others were near as big as the Top of the Thumb, which resembled so many Knots in it, it divided in the Middle, and continued separated about an Inch and a Half, and then re-united, it was of a more tender Substance than the Body of the _Cancerous Mass_, but of the same Colour, and was probably the Juice that was last applied to the _Cancer_, which assumed a Form agreeable to the Cavities it lodged it self in. Such Adherents as these are, I am more inclined to believe, are the Cause of the unsuccessful Attempts on _Cancers_, than any _Acid_ in the Blood; for I am of opinion there are few Persons unacquainted with Medicines that are capable of correcting its _Acidity_ when it happens; and had the Cure of _Cancers_ depended on that, I am positive they would not at this Time have had such ill Character. We have before shewed that _Cancers_ have generally their Rise from a Blow or Bruise, and that when the Body is in an healthful Condition, and the Blood and _Lympha_ temperate and sweet: Now if there always is an _Acidity_ of the Blood when Persons are afflicted with _Cancers_, the _Cancers_ must sometimes cause it, and not the _Acid_ in the Blood the _Cancers_, as is the Opinion of most of the Moderns. What has been hitherto said, is sufficient to prove that if Men will be always so sluggish as to acquiesce in the Dictates and Dogmatical Positions of their Predecessors, and not exert their Faculties in endeavouring to undeceive themselves; we must no longer expect our Art will receive any Advancements, but as Slaves to their Opinions content our selves with what we know already. Were not _Parisani_, _Riolan_ the Son, and _Plempius_, so much in the Interest of the Ancients, that when our Country-man, the assiduous _Harvey_, had discovered the Circulation of the Blood, they not only opposed his plain Demonstrations, but engaged in vigorous Disputes against him, tho’ at the last they were obliged shamefully to recant their Follies. _Celsus_ tells us, _Vix ulla perpetua Præcepta Ars Medicinalis recipit_; scarce any of the Precepts of the Medicinal Art are perpetual. And shall we engage then in the List with a few opinionative Men, that ground their Course of Practice on those Methods only, in which they have been brought up, and implicitly assent to the Conjectures of others. No certainly, this would be to strangle Truth, and extinguish the Vigour of our Wits with precarious Authorities. Consonant to this, Dr _Paxton_, in his lately published Treatise, tells us, _Thus Men, out of a trifling Distrust of their own Parts, will not use them; or out of Laziness of Temper, will not employ them, chusing rather to be wise or learned, by being adorned with Others Whimsies, than undergo any Labour, Fatigue, or Trouble of being really so_. I believe there are some Men that would rather contradict their Senses than deny the Authority of a darling Opinion: Of this, we have a sufficient Proof in an Instance, related by an _Italian_ Author before-mentioned. He tells us, _That a certain Publick Reader long Time versed and grown Old in the Books of_ Aristotle _being one Day present at a Dissection, and clearly seeing that the_ Vena Cava _takes its Rise from the Liver, confessed with Astonishment what his Senses discovered to him, but that he ought not therefore, by crediting his Senses, to contradict his Master, who constantly affirms all the Veins in Man’s Body to have their Original from the Heart; because, said he, it is much more easy for our Senses to be sometimes deceived, than the Great and Sovereign_ Aristotle. I here seriously confess, I have as much Veneration for Antiquity as any Person whatsoever; but it would be ridiculous, if, as One says, we should so far forego our own Judgments as always to follow the Foot-steps of Others, and to be certain of nothing our selves: For this would be to see with others Eyes, to hear with others Ears, and to understand with other Men’s Intellects; so that whenever we make Quotations from the Ancients to strengthen our Opinions, we ought to do it judiciously, and fully consider, whether their Notions of Things are consonant to the Experience of these Times. To prove to you, _Sir_, that I have not proceeded to apply my self to the Cure of so formidable a Disease, without a Precedent, I shall instance to you that _Fuschius_, a learned _Italian Surgeon_, had such a wonderful Reputation for it formerly, that some Authors say he was distinguished by a particular Title, which discovered his Success. His Method I have made use of, and tho’ by passing thro’ several Hands (the Author being mentioned by few) it has been stampt with wonderful Encomiums, I have not hitherto found it deserves it, notwithstanding I did not omit the most minute Circumstance in preparing the Medicine, or prosecuting the Directions; but in its proper Place, I shall take particular Notice of this, and several other Remedies, that have been recommended by some Authors, as substantial and extremely useful; for if in One or Two Instances they have been crowned with Success, by Degrees they are handed down as infallible in all Diseases of the like Form. To the former Account I may add, that Monsieur _Alliot_, _Physician_ to the Duke of _Lorrain_, has applied himself to the Cure of this Disease very successfully, as a _Schedule_ he published at _Paris_ some Years ago informs us; we are likewise assured by Mr _Boyle_ that Dr _Haberfield_, one of the Principal _Physicians_ of _Bohemia_, has had extraordinary Success in the Cure of _Cancers_; and the Sieur _Gendron_, Doctor of _Physick_ in the University of _Montpelier_, has done extreamly well on that Head; the latter of these Gentlemen I cannot mention, without making an Apology for not Publishing our Annotations on his Enquiries relating to _Cancers_ which was promised at the latter End of our Chirurgical Remarks, Printed above a Year ago; but I assure you, _Sir_, I was more inclined for some Reasons to offer what is therein contained, with several Observations made with the greatest Exactness, and to which, perhaps I may have an Opportunity of making several Additions, in a particular Treatise, so that the whole may conspire to finish a compleat Account of this Disease. I had at first a Design of enlarging considerably on this Subject in this Letter by adding various Things, but considering they might better find a Place in what I just now mentioned, and that you did not desire an exact History of the Disease, I resolved to omit them. I shall now proceed to give you some Instances of the Success of our Method, as being what you are most solicitous of, the Cases I shall relate shall be each of them different from the other, for I know you do not approve of that pompous Method of some Persons, that enumerate abundance of Instances of Cures when perhaps there is no great Difference in the Cases or the Method of treating them.

The most considerable Case that offered it self during our first Enquiries into the Nature of _Cancers_, was that of a Woman, who about Four Years before received a Blow on one of her Breasts, upon which it began to swell, grow painful, and after some time became all over livid, and of so prodigious a Bigness and Weight, that she was obliged to keep it suspended by a Napkin round her Neck: But in regard our Method was not put in Practice till by other Applications it was become ulcerated, we shall speak of it as such. The Patient, then, at this time complained of a very violent Pain, which extended it self to the Back and Shoulder, by the Communication of the Nerves (for those of the Breast come from the fifth Pair of the Spine, and from a _Plexus_ about the _Clavicels_.) To remedy this, she had taken no small Quantity of _Hypnotic_ Medicines, which, without Doubt, destroy the due Texture of the Blood, and so become prejudicial to the Patient, and disadvantagious to the _Surgeon_ that proposes a Cure. But because Persons generally find some Relief by Opiates, as they retard the determined Motion of the Blood, straiten the Nerves, and check the tumultuous and disorderly Influx of the Spirits; so, probably, in these Cases, their Use will be continued. Besides the acute Pain, the _Cancer_ was over-spread with fungous Flesh, its lower Part extreamly hard, knotty, blackish, and its Basis seemed inclinable to fix; the Matter which was discharged was thin, reddish, and stank abominably. This was the Condition of this poor Woman, when we first applied our grand Dissolvent; the Pain she was attended with the first and second Day after was inconsiderable, nor did she complain of more afterwards, than would have been procured by the most mild and easy Remedy the Dispensatory affords. In four Days Time we found a very evident Alteration for the Better; for the Consistence of the Matter was changed, and the Surface of the _Cancerous Mass_ became somewhat soft, we continued the Use of the same Medicine, and in a few Days more some part of the _Cancer_ came away with the dressing. In short, in about six Weeks time, the whole Substance was entirely gone, and nothing remained to be done but to heal the Ulcer, which was effected in about a Fortnight. During the time she was under Cure we gave her a proper internal Medicine, not calculated to destroy the Acidity of the Blood, but to dispose the whole _Cancerous Mass_, with its Appendices to come away, which might otherwise, as the Seeds of the Disease, cause it to spring again: Thus was this Patient, (after so great a Fatigue she had undergone before she came to me) perfectly cured, and has continued so to this Time, without any manner of Inconvenience as she lately told me, it being a long time since she has been well.

A Gentlewoman near fifty Years of Age, by some Accident received a Blow on her left Breast, which in a few Days was succeeded by a considerable Tumour, whereupon she applyed herself to a _Surgeon_, who immediately let her Blood, ordered her to take the _Lap. Hibern._ in Posset-Drink, and embrocated the Breast with _Ol. Succini_: By the use of these Means the Swelling was much abated, a small Hardness only remaining, which did not exceed a small Wallnut in Bigness; in this State, with very little Pain, she continued above a Year; but being persuaded to apply an _Emp. de Ran. cum Mer._ to it, it encreased very apparently, was extreamly painful, and in Seven Months time became as big as a large Egg: After this she made use of a Woman who was reputed Famous for these Cases; but by One or Two of her Applications the Tumour became as big again as before: In short it continued to encrease gradually from that time, till the whole Breast, which was of a monstrous Bigness, and which was judged not to weigh less than Eight Pound, in time became entirely _Cancerous_. It was at this time that I saw it the Skin was very livid, looking sleek and shining, and seemed ready to open, as being scarce capable of longer containing such a prodigious hard _Mass_ as laid concealed under it, and was in all Probability as big as the Breasts of the _Ammonian_ Women, of which _Juvenal_ thus speaks, _In Meroe, crasso majorem Infante Mamillam_. She had been with various experienced and reputable _Surgeons_ before, among which was One not long ago deceased, who was justly looked upon as an Ornament of his Profession; but not one would willingly attempt a real Cure by cutting it off, or any other Way: They only prescribed some palliating Remedies to remove the Pain and prevent its Breaking. I was animated by my former Successes, and prevailed with my self to undertake it, not thinking I was at all blameable if my Success in so extraordinary an Affair contradicted the Prognosticks of so many worthy Gentlemen; and though it did, I shall at all times think my self obliged to pay a Deference to them. I began the Cure by removing the Integuments from the upper Part of the Cancerous Substance, but did not wait for a Separation of the Slough the Escarotick made for fear of being incommoded in my Procedure by a Fungus; For this Reason I mixed some of our Dissolvent with a digestive Ointment, by which Means I had a Part of the _Cancerous Mass_ came away with it, without any Trouble to my Patient. I continued this Method of Dressing several Days longer, with very little Alteration; but upon a Complaint of a Pain between the Shoulders, I was obliged to change my Medicine, and foment the _Cancer_ with an Infusion of some of those Herbs that contain many _Volatile_ attenuating and active Particles. And here I cannot but remark, by the by, that Applications to the pained Part would have been of no Effect, as I have many times observed, and particularly in a Woman which had a Cancerated Breast, that was violently afflicted with a Pain in her Arm on the same Side, which would not be removed by any of the Applications the Person that had the Care of her made use of the affected Arm. To this I might subjoin a very pertinent Case from _Galen_; but I fear I shall digress too far. The Pain of my Patient’s Back being removed, I proceeded to apply the Dissolvent, which so softened the Superficies of the _Cancerous Mass_ that in Three or Four Days Time I could take off above a Quarter of a Pound of it with the Edge or Back of my Incision Knife, and my Patient not so much as feel me, this I continued to accustom my self to, because it would have been more tedious to have waited for the coming away of the _Cancerous Mass_ of it self. Sometimes I varied my Applications as I saw Occasion, but, as my Patient confessed, I scarce put her to any more Pain during the Time her Breast was dissolving (abating for the Pain of her Back) than there is in the dressing of an Issue. The prodigious Bigness of the _Cancerous Mass_ made the Cure the more tedious, for it was above Three Months before all of it was entirely dissolved and gone; but this being at length surprisingly and very happily effected the _Cancerous Ulcer_ (the last Part of the _Cancer_ that came away left) was incarned and cicatrized by an Infusion of vulnerary Herbs, to which was added a small Quantity of Tincture of Myrrh: Thus was this Cure entirely compleated and my Success in it confirmed that _French_ Proverb, which says, _It is better to be condemned to die by the Doctor, than by the Judge._ I did not make use of that internal Medicine I mentioned in the former Case, because here I found no pressing Necessity for the Use of it, but some other proper Physick was taken to dispose the Ulcer to heal, as one would have done in any other Case. Upon the whole of this Cure, I cannot say whether I had more Trouble with the _Cancer_, or in endeavouring to oblige my Patient to a strict Observance of some of the Non-Naturals she so often erred in. There is nothing can create a greater Trouble to the _Surgeon_, than to find Patients negligent of their Healths, by not endeavouring to prevent or regulate Miscarriages, nor taking so much Care of themselves, as they expect the _Surgeon_ should take of them. The Rules and Directions of _Physicians_ and _Surgeons_, given to their Patients, we have Reason to believe were not so often violated formerly; for in some Places they obliged themselves very strictly to the Observance of them, and some Historians give us an Account that _Selucus_ made a Law; that if any of the _Epizephyrian Locrians_ drank Wine, contrary to the _Physician_’s Direction, though they escaped the ill Consequents that might have attended it, Death was their Punishment, because they did contrary to what was prescribed them.

A Woman about Thirty Years of Age had been for a considerable Time afflicted with a hard painful Tumour under her Tongue, for the Cure of which she had applied her self to various Persons, but without Success. When I saw her I found the Swelling to be hard, painful, of a livid Appearance, and incommoded her so much in speaking, that she could not pronounce her Words articulately. I was of the Opinion of some Gentlemen that had seen it before me, _viz._ That it was undoubtedly _Cancerous_, and as such I proceeded to cure it; but I met with more Difficulties in this Case than I at first expected, for after I thought the _Cancerous Substance_ had been entirely dissolved, and I had reduced the Ulcer to a very narrow Compass, it began to swell again, and in a short Time enlarged it self to almost the Bigness it was at first: This put me upon a Necessity of making an Incision into the Body of the Tumour, that I might commodiously come at the remaining Part, and so dispose some little Dossels of Lint, armed with our Dissolvent, that they might have their desired Effect, and this in every Respect answered what we proposed; so that we proceeded immediately to incarn the Ulcer, which we did by a Lotion prepared of an Infusion of some vulnerary Herbs, and _Mel. Rosar_. Thus was this Woman perfectly cured, and has continued well about a Year.

Because I have always found greater Difficulty in treating _Cancers_ of the Mouth and Lips than those of the Breast, I will here relate an Instance of one upon the lower Lip that proved extreamly troublesome. It sometimes happens that one, or more, of those Glands which are spread on the Inside of the Cheeks and Lips, called _Buccales_ and _Labiales_, receive some Damage by a Bite or Blow; upon which they generally tumefy very much, become painful, and in Process of Time (if proper Means are not made use of) may become _Cancerous_. Such was the Case of a Woman about Thirty Years of Age, who having had a Blow on her lower Lip, neglected it till it was considerably tumefied, grew very painful, and became extreamly troublesome to her. The Circumference of the Swelling when I saw it, which was many Months after the Blow was received, was very much inflamed, and a small Quantity of _Icorous_ Matter discharged from several small Pustules, which over-spread it; the Middle, which was the Body of the _Cancer_, was hard, of a whitish Colour, and moveable; it’s Sides being only connected to the contiguous Parts by some small Filaments that were detached from it. The same Thing Doctor _Gendron_ has discovered in an ulcerated _Cancer_ on the Forehead of the Servant of a certain _Marquess_, as he observes in his Third _Chapter_ of the Tract we have before mentioned. I began with my Patient by applying cool and temperate Remedies, till the Inflammation was considerably abated; after this I applied our Dissolvent, which operated so mildly that my Patient was not sensible of near so much Pain as before she was apprehensive of: In short, the Body of the _Cancer_ was removed and a good digested Matter discharged from the Sore. Now all the Difficulty was after what Manner we should proceed to dispose the little _Cancerous_ Branches in the Skin to come away, but this we effected after the following Manner; the Consistent of the Medicine we before applyed, was such as was no way qualified for rooting out the Cancerous Filaments, whereupon we were obliged to procure it’s Dissolution in a proper Menstruum, though it required a considerable Time to do it; by this means, we soon found, that what before was ineffectual was now capable of effecting what we desired. This being done, the Ulcer was incarned by a Sarcotick Infusion (for I never use Ointments in these Cases) and cicatrized by the common drying Plaisters. It is to be observed, that the Scar still continues hollow (it having been healed near Two Years) and not like those that are the Consequents of well ordered simple Ulcers.

The following Observation contains an Account of one that was cured of an incipient _Cancer_ in her Breast, by Internals. I was the rather inclined to set down the whole Process of this Cure, because by these, or such like Medicines, Persons under the same Circumstances may perhaps be cured, though by some they may be thought incurable. The Case is this; A Gentlewoman, Thirty Years of Age, of a thin spare Habit of Body, by some Accident received a Blow upon One of her Breasts, which put her to an immediate Pain, and that very acute; but it lessened upon her being let Blood, and the Application of a discutient Plaister: However, in a few Days, some of the glandulous Grains of the Breast became indurated, and in Process of Time, by their Increase, they were rendered painful. At this Time she sought out for fresh Advice, and continued Two Months under the Care of a Person she was recommended to; but Things not succeeding according to Expectation, she became a Patient to Three or Four more. During this Time the Lump continued to encrease but slowly, and at the Expiration of Six Months it appeared to be a very hard painful Tumour in the Middle of the Breast, but no bigger than a Hen-Egg; whereupon it was thought proper to commence her Method of Cure by exhibiting the following _Pills_. ℞ _Pill. Tartar. Quercetan._ ʒß. _Calomel_ gr. viii. _F. Pill._ N^{o.} 5. These were likewise continued twice a Week during the whole Cure; after this, was ordered the following Infusion, ℞ _Vin. Rhenan._ ℔ii. _Milleped._ ℥ii. _Ocul. Canc._ ℥ß _Croci._ ʒii. This was not to be taken alone, but when it had stood Four and Twenty Hours, three or four Spoons-full of it was to be mixed with a Draught of the ensuing Dietetick-Drink, and taken in the Morning, and at Four of the Clock in the Afternoon. ℞ _Rad. Sarsaparill._ ℥ii. _Chinæ_ ʒvi. _Fig. Sassafr._ ℥i. _Corn. Cervi_, ℥_Sem. Correand._ ℥ß. _Sant. Rub._ ʒii. _Coq. in aq. Font. Congiis 4 per Horæ dimidium, deinde stent Clause super Cineres Calidos per Horas_ xii; _postea ebulliant ad tertiæ Partis Consumptionem_. By the Continuance of these Means about two Months, and observing a regular Method of living, the Cure of this Patient was effected; though by some she had been looked upon as incurable, unless she would submit the cutting it out, which is not often attended with Success.

Perhaps, _Sir_, here you may object, that it is acting disengenuously, and not like a Friend, to give you an Account of those Persons only where I have succeeded. To this I answer, that excepting one Woman, that was emaciated almost to the last Degree by the excessive Discharge of a fætid Icorous Matter from her Breast, and an Abscess under her Arm, and who was carried off by a violent Loosness, I never had a Person miscarried under my Care, where I proposed a Cure. That poor Woman I suffered my self to be persuaded to take care of, having but little Prospect of effecting it, yet my Endeavours succeeded so well, that had it been in our Power to put a Stop to her Loosness, I am of opinion she might have been cured.

What has been hitherto said, I do not question but is sufficient to satisfy you, that this formidable _Disease_ is not so rebellious, but that it may be sometimes conquered by Art; and I might here relate a Case I have at this present Writing, wherein not only a Part of the _Cancer_ was fixed, but there were hard _Cancerous_ Knots extended to the Arm-pit; and yet this seems to be almost well; the Ulcer that remains, and which heals daily, not being much broader than a Crown Piece. But in regard the Patient is not entirely cured, I shall reserve this Relation untill another Opportunity; though I will embrace the present to assure you that I am,

_SIR_,

_Your very respectful Brother,

and Humble Servant,_

W^m. Beckett.

_Hatton-Garden,
July 12, 1711._

_A Solution of some Curious_ Problems _concerning_ Cancers.

PROBLEM I.

_Whether the Cancerous Juice is Corrosive, or not._

[Sidenote: _Vide_ Riolanus, _Cap._ 13. _Sect._ 2.] We cannot come to a 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._