A Collection of Chirurgical Tracts

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

Vide Ætius Tetrab. 4. Ser. 4. Cap. 44.

Vide Arceus, lib. 2. Cap 3. de Curand. Vulnerib.

BY the Account we receive from Authors we cannot be positively assured, whether there was any particular established Method in the first Ages of this Art, for the Performance of this Operation: This we are only assured of that there are some Circumstances which relate to it, that have been taken Notice of; the most considerable of which is, that the actual Cautery was to be applied immediately after the Abscision; this they advised, not only to put a Stop to the Flux of Blood, but likewise to correct the ill Quality of it: It is to be observed, that they ordered always, upon such an Occasion, Defensatives to be applied to the contiguous Parts, to prevent their being inflamed; but for as much as they were sensible the actual Cautery would procure an Eschar, they recommended the Use of Digestives to separate it; after which, they proposed to heal it as a common Ulcer. The very next Advance this Operation received, that we have met with, was by that Accurate Writer Franciscus Arceus, who obliged the World with an exact and methodical Account of the whole Method of Procedure in extirpating a Cancer in the Breast; though this Author would only venture on those that were not Ulcerated, those that were he looked upon as incurable. We do not find that this Method was recommended to the World by any remarkable Histories of Cures effected by it; whether it proceeded from the Unsuccessfulness of the Attempts, or its Disuse, we cannot determine. Fabritius Hildanus likewise made a considerable Step towards the Encouraging the Performing this Operation; and he assures us, he has more than once done it with Success; he did not only influence his Cotemporaries to revive an Operation, that was, perhaps, almost grown out of Date, by the Histories of some Cases he recites; but obliged them with the Figure of a Pair of Forceps, which in this Operation are very convenient to engage the Breast, and thereby prevent the Pain the Patients are sometimes put to, by piercing the Breast with Needles armed with Silk to suspend it. There are several Ways of performing the Operation, mentioned by later Practitioners, but at this Time there are few that are willing to be concerned in it. A very considerable Author speaking of extirpating a Cancerous Breast, advises us to take care we do not cut the Pectoral Muscle in the Operation: But we have seen a very remarkable Case of this Nature, where a Part of that Muscle was cut away, and the Cartilages of the two of the Ribs laid bare, and the Patient happened to be cured. Now if our Predecessors had so great a Respect to the avoiding the wounding of this Part, as to make their Incisions too superficial, their Operations must be in all Probability unsuccessful; for we are very well assured by Experience, that their actual Cauteries will have no good Effect here, nor will they consume the remaining Part of the Cancerous Mass. We have elsewhere shewed, that this Substance upon boiling becomes hard and friable; and we will here take the Liberty to give our Opinion of the Use of Cauteries in this Case. The Cancerous Substance we take to be nothing more than a Transformation of the small glandulous Bodies, which form the Breast, and a Lymphatick Juice, intimately incorporated therewith, into a hard, close, whitish, and (by common Medicines) indissolvable Mass. In some Cases, perhaps, it may receive some Addition from some Juices, which may distil from the contiguous Fibres. This being granted, what Benefit, can we reasonably imagine, will ensue on this painful Method? Will not the Fire, by causing the more Fluid Parts of the Mass to evaporate, actually dry up, torrefy, and harden it; and so dispose it for displaying a Train of mischievous Effects, on the contiguous Parts? and all this without any very apparent Decrease of it too: Nay, the very reducing of it to such a Consistence, which very much resembles a Piece of burnt Horn, is sufficient to procure a perpetual Pain, seeing Medicines can hardly soften it, so as to reduce it to its first State.

PROBLEM IV Whether Salivation will Cure a Cancer

THE extraordinary Success this Method has been attended with, in some Cases of the greatest Difficulty, has so far recommended it to the World, that it is at this Time become of so great Repute, that there are few Persons but what will willingly embrace it, if proposed to them, provided they have found former Methods prove ineffectual. We once knew a Person, who laboured under an ulcerated Cancer in her Breast, advised to it, and who had certainly under-gone it, though contrary to the Opinion of some Persons concerned, if in three or four Days time she had not been reduced to such a weak Condition, that it put an End to the Controversy. That a Salivation has cured the most malign and spreading Ulcers, and those that have been of several Years continuance, notwithstanding their Edges have been high, inverted and assumed the Consistence of a callous Body, we have found by several Instances; but that it should cure a Cancerous Ulcer, an Ulcer which is chiefly seated in a transformed animal Substance, and which has no Correspondence with the contiguous Parts, is what we cannot believe. One of the principal Effects of Mercury, if prudently given, is, that it attenuates the Juices, clears the Canals, destroys the ill Quality of that Fluid that has a Hand in causing any Obstruction, and renders the Juices temperate and sweet. By effecting this, it is, that it cures so many different Diseases, which perhaps have not so great a Diversity in their Causes, but have different Appearances, which depend upon the Variety of Parts, where the Cause operates. From hence any One may judge, that a Person who discovers a certain Method of curing Cancers by Medicines only, will find that it will not consist in a Secret for purifying the Juices, which can have no Effect on the Cancerous Mass, so as to procure it’s Dissolution; and without a Remedy for which his Method will be always unsuccessful. Mercklin, in his Treatise de Transfus Sanguinis, page 35, tells us we have no Reason to believe we may have Success from Transfusion in a Cancer, nor indeed would Injections succeed better; though, perhaps, by this Means, it is possible so to alter the Fluids, that Ulcers, not Cancerous, may be cured in a short Time, as it once happened to a certain Person, who being under Cure for an inveterate Pox, had some Rosin of Scammony infused in the Essence of Guaiacum, injected into his Veins, which Vomited him excessively; but his Ulcers were healed in three Days Time. From what has been hitherto said, it is evident, that a Salivation can never cure a confirmed Cancer, because it is not capable of procuring a Dissolution of that hard Substance, which is the real Cancer it self. The Glands we have observed, with the extravasated Lympha, and its Vessels, are perfectly changed to a different Substance to what they were before, all which make a Mass of such a Nature, that it will be impossible to procure it’s Dissolution by any inward Means. If the Cancer was nothing more than a Coagulation of the Juices in the Vessels, or other Canals, or Pipes, the Cure might be much more easily effected, but as the Cancer is conjoined with such Circumstances as we have mentioned, we may affirm the Cure will be altogether impossible without the whole Substance with it’s Appendices or Branches (which we have found they often have) be taken away; or a perfect Dissolution of all of it be procured by some external Remedy, which is capable of operating on it after such a peculiar Manner, as to dissolve the Cancerous Substance, without having any such Effect on the contiguous Parts.

PROBLEM VWhether Cancers are Curable by Causticks

THE Difficulty that those of our Predecessors who had Courage enough to attempt the Cure of Cancers, must unavoidably meet with, obliged them to enter upon several Methods of Practice, in order to be capable of surmounting it; and there have not been wanting for these several hundred Years last past, some Gentlemen in the Republick of Medicine that have proposed to conquer this Rebellious Disease, by the use of some particular Causticks, they have recommended. It is foreign to my Design, to give an Account of the Composition of the several Remedies, they have been big with the Expectation of Success from; I shall only take notice of one or two not very pompous Preparations, that by some Persons I know, have been looked upon as extraordinary as any that have been transmitted to us. Guido, who I think I may justly say is one of the best Authors of so ancient a Date, has been very lavish of his Encomiums on Arsnick, and after him Fallopius, Rodericus a Castro, Ossenius, Penotus, Faber, Borellus, and others, have recommended it in some particular Preparations. That of Fuschius, who is said to have cured abundance of Persons of Cancers, in England, Germany, and Poland, having had the most said in it’s Commendation, required our more particular Notice; Hartman calls it Pul Benedictus, which whether it deserves that Title, we will leave to the Reader to judge, after we have faithfully recounted the Effects of it. Its Preparation is as follows: ℞ Arsenici albi ℥i subtilissime pulverisetur per dies 15 de die tertio in tertium affundatur Aq. vitæ, ut cooperiat pulverem, post triduum Aq. vitæ abjiciatur, ac nova affundatur, ac misceantur. Rad Dracunouli Major, mense julio vel Agu. collect & in taleolas scissæ ac in loco ventis perflatili exsiccatæ ℥ii. Fuliginis Camini splendidi ℥iii redigantur omnia in subtilissimum pulverem super lapidem marmoreum, & servetur in Vase bene clauso vitreo. Ante annum vero ad usum non erit it a commodus. This Powder I applied to a Cancerated Breast of a Woman, under thirty Years of Age, after having made a Sore by applying one of the milder Causticks; the first Night it was made use of, it caused a great deal of pain, and the next Day, the Breast appeared very much tumefied and inflamed, a small quantity of Gleet, having discharged on the Bolster: in short for fifteen Days she was not free from pain, she had a Fever, was attended with frequent Vomitings, Faintings, and several other Disorders. I could afford her but very little Relief by Internals, or the most cool and temperate Applications to the Breast; nor was it in my Power to remove the dressing, it adhered so fast to the Sore. There was a Discharge of a bloody ferous Juice for twelve Days in a moderate quantity, after which the Matter thickened, and it began to smell somewhat offensive, at the end of fifteen Days the Dressing dropped off, and with it came away about two Ounces of the cancerous Mass. The Reader may easily imagine that making so small a Progress in such a time, and that at the Expence of so much Pain, I could easily prevail with my self to desist from the Undertaking, for the second Application would have been attended with the same Inconveniencies as the first, which to any Persons that entertains such a concern for his Patients as he ought to do, must be very fatiguing; in short, after this I made use of that Remedy I had elsewhere mentioned, and which from its Effect was properly enough called a Dissolvent, with this by the Blessing of God the Cancerous Substance was consumed in about three Weeks, and a perfect Cure compleated in not many Days after, the Patient which I saw lately continuing perfectly well, it being the first Case that ever Providence directed me to the use of the Remedy in. Hildan has an Observation very pertinent to what we have before related; he tells us, that the Powder so much celebrated by Penotus, and which is much the same with that just now mentioned, being applied to a Cancer, was succeeded by such ill Symptoms, that it killed the Patient in a few Days. We are informed in the communicated Observations of Riverius, that a Foreigner extirpated a Cancer, that had began to Ulcerate in the Breast of a Woman of fifty Years of Age, by the following Application: ℞ Arsenici ʒi. Salis Armoniaci ℥ii. Sublimat. crud. ℥iiii. Aq; Fortis ℥i. These were to be distill’d to Dryness, then an equal Weight of distill’d Vinegar put thereto, which was to be distilled again, till the remaining Matter, became of the Consistance of a Paste. The Surgeon bathed the Cancer with hot Wine, and rubbed it with Cloths for some time to irritate it, then he spread some of his Composition on a Bolster six times less than the Tumour, and applied it; in twenty four Hours time, it made an Escar as large as the Swelling, so that it wholly consumed the Cancer; after the Separation of the Escar he incarned the Ulcer and cicatrized it. It is very observable, that he did not engage in this painful Process, without immediately causing a Fever, which was attended with a Vomiting, Loosness, and much Provocation of Urine; which Symptoms lasted two or three Days, for Nature was disordered by the destructive Quality of a venemous Remedy. Paracelsus, Faber, and some others, make mention of Arsnical Preparations, that procure but little Pain in their Operation; I had a Design of making a Trial of some of these Remedies, had I not in my Enquiries met with what was very satisfactory to me, though after knowing what I have related, I should have always cautiously avoided the use of any Remedy, in which the Arsnick had not undergone such a Preparation as I should have approved of, because I am assured it may procure very mischievious Symptoms, though in Substance, it do not so much as touch the Skin, witness the Amulets, in which it has been the chief Ingredient, and of which there have been such direful Accidents related by Crato, Massaria, and Zacutus Lucitanus. I do not think it impossible, but that Arsnick may be prepared after such a manner as may, by the addition of some convenient Body, or depriving it of its noxious Particles, qualify it for effecting uncommon things in the Cure of this Disease, without causing the Surgeon to repent the use of it. I remember that Helmont somewhere says one may easily enough correct several sorts of Poisons, so that they shall not be deprived of their Force, when we destroy their Virulency. Many Instances of this Nature we meet with in Mr Boyle, and some others; but that which makes most for my present purpose, is, what is mentioned by the last Honourable Gentleman, of a very ingenious Man he knew, that was famous, as well for his Writings, as for a Remedy to cure ulcerated Cancers in Womens Breasts, without any considerable Pain. He assured our Author that his Medicine was indolent, and mortified the ulcerated Parts as far as they were corrupted, without disordering the Party, and this Remedy it seems partly by the Confession of the Gentleman, was reasonably enough supposed to be a Dulcification of Arsnick; one would think that the mention of this very Remedy, with Monsieur Alliot’s, and that recommended in the preceeding Letter, should be sufficient to influence the inquisitive of our Profession to farther Enquiries, which must be certainly an Undertaking, worthy the noblest Spirits. To conclude, we cannot say, but there are many Cancers that may be cured by Causticks, but the Person that is to undergo it, may very well answer, as a certain Patient did, who’s Thigh was to be cut off, Non est tanto digna dolore Salus. The Preservation of Life would be too dear bought at the Price of so much Pain. This puts me in Mind of what is related of Galienus the Emperor, who it seems had for a considerable time been very grieviously afflicted with a Sciatica, a certain Physician undertaking to cure him, performed indeed his Promise, but nevertheless made him undergo a thousand painful Experiments; whereupon, the Emperor one Day sent for, and thus said to him, Take Fabatus two Thousand Sesterces, but withal, be informed I give them not for curing my Sciatica, but that thou may’st never cure me again.

PROBLEM VIWhether Cancers are Curable by internal Medicines

THOUGH this Problem at first View may seem to be too near allied to that which proves the Impossibility of curing cancerous Tumours, whether ulcerated or not, by Salivation; yet in regard there are some Persons, that tell us the Disease is superable by some internal Remedies, which operate after a quite different Manner, to those generally given to procure a Salivation, we shall enquire into one of the most considerable of them, related by a Person whose Memory we have a very great Value for. And we shall the rather take Notice of this particular Remedy, because we have elsewhere spoke of the Success of it. It were no very difficult Matter for me to mention several internal Medicines, out of our Chirurgical Writers, more especially those that have been Favourers of Chemistry; but I shall purposely decline it, because to speak freely, I suspect that most of the Remedies, though much has been said in the Praise, have not been sufficiently examined by those that recommended them. To this we may add, that had the Authors of them considered the vast Difference there is to be observed in Cancers, they would not have so suddainly and positively determined, that their Medicines were of use in these Cases in general; seeing we must have regard to absolutely different Intentions, in those that are not ulcerated, and those that are, and those that are a hard Tumour, and those that are flat, and likewise when they are conjoined with Circumstances, which are often enough to be met with. The Honourable Mr Boyle in his Usefulness of experimental Philosophy, tells us, that he was informed by credible Persons, of a certain English Woman above sixty Years of Age, who had lain long indisposed with a Cancer in her Breast, in an Hospital in Zeeland, and was by Doctor Harberfeld, with one single inward Remedy perfectly cured in three Weeks; the Relation was made by a Doctor of Physick, who was an Eye Witness of the Cure, and another Person who not only saw the Cure, but knew the Woman before, and out of Charity, carried her to him that healed her. Our Author was informed, that the Chemical Liquor the Doctor constantly made use of, does in the Dose of about a Spoonful or two, work suddainly and nimbly enough by Vomit, but hath very quickly ended it’s Operation, so that within an Hour, or less, after the Patient has taken it, he is commonly well again, and very hungry. He adds, that having some of the Liquor presented him, he found the Taste to be offensive enough, and not unlike that of Vitriol, which by the Taste and emetick Operation, was guessed to be it’s principal Ingredient. The Relators assured our Author they had been in England, as well as elsewhere partly Eye Witnesses, and partly Performers of wonderful Cures by the help of it alone, under God, in the King’s Evil; insomuch, that an eminent Gentleman of this Nation, hath been cured by it, when that Distemper had brought his Arm to such a pass, that the Surgeons had appointed a time to cut it off. Now, who is there, that upon reading this Account would not think the Doctor a very happy Man, that was Master of so valuable a Secret; but alas! How satisfactory would it be to the World if the hundredth part of the Remedies that have been handed down to us, had a Power of effecting those things that are ascribed to them, without being attended with any ill Consequences. I assure you, Reader, I have made use of this very Remedy, for since I mentioned it as the Doctor’s having great Success from it; I met with the true Preparation of it, as it was communicated to Sir Kenelm Digby by Doctor Havervelt, or Haberfield, for the Cure of Cancers, the King’s Evil, and old Ulcers. It is as follows. ℞ Dantzick Vitriol, calcine it till it be yellow, then grind it with Salt, or Salt Petre, the ordinary proportion with this Sublime Mercury, which Sublime once again by it self, then take only the Cristaline part of it; of this take ℥i, grind it to a Subtile Powder in a Glass Mortar with a Glass Pestle. Put this into a Glass Bottle, and pour upon it a Quart of Fountain Water, stop the Bottle close, and let it stand thus for some Days, shaking it often; after it is well settled pour off the clear, and filtre it; take a Spoonful of this Liquor, which put into a Vial, and put to it two Spoonfuls of fair Water; shake the Vial well, and let the Patient Drink it in the Morning Fasting: As to the quickness of its Operation, and the making the Patient Hungry, I found it at first to agree with what Mr Boyle says of it; but upon giving it three or four times, the Patient would afterward complain of a Languidness, which was ushered in by a Sickness at the Stomach; after this, they would be attended with a Heat or Soreness of the Throat, immoderate Thirst, convulsive Motions of the Stomach, &c. Some of which Inconveniencies would continue for many Hours together. It was upon Account of the Melancholy Reflections of bringing the Patients into such Disorder, and their Unwillingness to endure such Fatigues, that I had never Courage enough to proceed in this Method. I cannot but say, upon the Alteration I found in a Patient of mine, from the use of six Doses of this Medicine, that it may as well as some other churlish Remedies, cure some flat ulcerated Cancers, where there is no Tumour to dissolve, in Persons that are capable of often repeating it, which I think is sufficient to put us upon farther Enquiries, that we may be able to accomplish such Undertakings without bringing upon the Patient such a Train of mischievous Accidents.

POSTSCRIPT

What follows is taken from a Manuscript which at this time 1714–15, belongs to one of the Family of the Pains, that have for a long time pretended to cure Cancers: In the Margin is this Note, (Used by my Father, and Grandfather, and Brothers, and known as a thing excellent by long Practice in our Family of the Pains:) The Book was lent me by my Brother Dobyns, who had it from one of the Family, a Patient of his.

The Red Caustick

To eat all Superfluous Cancerous and Schirrous Matters gathered hard in the Edges or Sides of any Ulcer or Cancer, breeding upon the Mouth, Face, Nose or Valva. Take of Bole Armoniac one Ounce, of yellow Arsnic three Ounces, powder them and searse them fine, pare an Apple or two and take of the Pulp and put so much of it to the Powder (beating of it together in a Mortar) as will make it of the stiffness of Dough, then make it up into round Balls of the bigness of a Walnut, dry them in a Chamber-Window till they be hard enough. When you use these Balls shave a little off from them into your Hand, and moisten the same with a little Spittle, and rub it well about the hard Foot of the Noli me Tangere, and all over the Head of the same, and after that you have gathered him up into the Ligature and knit him hard up (for it seems they used a Ligature smeared with the Medicine) then apply your Preparation before-mentioned, and lay fine Holland Raggs dipt in the following Red Water, all over the said Caustic, and so let it lye till it fall off its self. Note, The Quantity of Caustic laid on, ought not to be much, and yet sufficient to work its effect. It worketh with great Pain for twelve Hours or more, and after that by Fits, like the Tooth-Ach; as the Pain worketh off it causes great Inflammation and Swelling about those Parts it is applied to, but this does not continue above four or five Days; so meddle not with it till the Caustick comes off. Then you may for three or four Days dress the Inflammation with Diachylon Plaister, or the Red Water warm.