A Collection of Chirurgical Tracts

On November the 4th, 1707, it happened, that during an Engagement between a small English Vessel and a French Privateer, near Margate, one of our Men was unfortunately wounded by a Bullet, which past through the middle of the Os Frontis. The Surgeon aboard the Ship immediately enlarged the Wound, by making an Incision through the Integuments, but could not discover the Bullet; whereupon he dressed him up, and the same Day being set ashore, he was dispatched for London. On Thursday the 6th Day of the same Month, he arrived, having walked much the greater part of the way in that time, which is about 66 Miles; the same Day his Surgeon endeavoured to extract some Pieces of the Bone, which discovered themselves through that Aperture which was made by the Bullet, but without Success; for they consisted chiefly of the internal Table, which were much larger than the Hole in the external: Upon this the Wound was immediately drest up, and a second Attempt was made a Day or two after; but it proved as successless as the former. In the mean time, the Patient continued to be very hearty and well, and seemed to be no more indisposed than if he had only received a slight Wound of the Head. The opening the Skull with the Trepan was proposed, and which would probably have been put in Practice in a Day or two’s time: But on the Sabbath-Day Morning following, after he had rested well all Night, he was seized with such violent convulsive Motions as were very surprizing; during which he expired. The Body being laid on a Table to be dissected, all it’s Parts appeared so prodigiously inflated, that the Person, when a live, being one of the largest Stature, it seemed perfectly monstrous. A Puncture being made in any Part through the Integuments, there was nothing discharged but a subtile Matter or Air; immediately after which the Part subsided, though before on a Compressure of the Fingers it would receive such an Impression as is observed in Oedematous Tumours; but it would suddenly return to it’s former State. The Surface of several of the Parts appeared livid and vesicated. The Skull being opened, the Bullet dropped out of the Brain, all the Fore-part of which was corrupted, and abounded with a thick yellowish Juice, of a very offensive Smell; there were two or three very large Pieces of the inner Table of the Skull, with some smaller that were found among the lacerated Membranes, and lodged in the corrupted Brain.

This Case is so particular, that it may not be amiss if we make some Reflections on it.

We are very well assured, Sir, that it has been a Matter of very great Surprize to several ingenious Men, to consider how the various Operations of the Body have continued to be performed, when those Parts which were so absolutely necessary to the Well-being of the Animal, have been naturally or accidentally disordered to such a degree, as to suffer a perfect Confusion of their Parts: And of this we find Variety of Instances in those Authors, who have very obligingly applied themselves to relate the Histories of deceased morbid Bodies. But that the Brain it self, which is the very Source and Principle of all Animal Functions, should, after it has undergone such a Violation as we have observed, continue several Days without incommoding the Person in the least respect, is really very remarkable; for if we do but consider what an absolute Necessity there is for a constant Supply of Animal Spirits, to empower the Parts to perform their mechanical Actions, and at the same time reflect on the Disorder and Corruption of that Part, whose Office it was to secrete a sufficient Quantity of those Spirits, we might very reasonably expect a considerable Alteration in the whole Body. One might very well think, that from the Deficiency of Spirits that would ensue, the Parts could no longer continue to perform their Actions, but must gradually lose their Power and Spring, and at length become in a manner destitute of Motion: For we can scarce perswade our selves, that Nature in this Case is so provident as to suffer the Cerebellum and Medulla Spinalis to filtrate the Spirits in a greater Quantity, that they might supply the Exigencies of the Body.

There still remains some considerable Phænomena to be accounted for, as the convulsive Motions, the prodigious Inflation of the Body, &c. As to the former, it may be perhaps accountable from the violent Conflict we may imagine to have happened on the mutual Engagement of the Juice that was found so plentiful in the corrupted Brain, and that which had undergone no Alteration from it’s original Purity. Add to this, that the Animal Spirits in the Nerves receiving some ill Impressions by the Accession of some of those impure Particles, could no longer sally out upon the Command of the Will to any particular Part, but must consequently so irritate the Nerves, as to cause their Extremities to contract themselves; upon which Account the Blood becomes imprisoned in the muscular Fibres, which abridging their Length by enlarging their Diameters, the Parts must necessarily suffer involuntary Contractions: At the same time those minute Capillary Extremities, which terminated in the Miliary Glands, were probably so contracted, or crispt up, as perfectly to close the Orifices of the excretory Ducts of those Glands, which are the only sudatory Pores: By this means all that vast Quantity of Matter which is usually discharged by insensible Transpiration, became imprisoned underneath the Integuments of the Body, and so distended all its Parts to such a prodigious Degree, as was observed. This Constipation of the excretory Ducts, and crisping up of the Extremities of the Nerves, might likewise have a considerable Effect on the small Branches of the Arteries and Veins which accompanied them; for by this means the Blood they contained might be obliged to stagnate in the Glands, which must occasion an Enlargement of the Diameters of those minute Vessels; and so the livid Colour which was extended on several Parts might be probably procured: Besides this, the Blood being in such a comprest State, some of its more fluid Parts might be exprest from it, which lodging underneath the Cuticula, might make the Parts appear to be vesicated; there is nothing more certain, than that Animal Bodies perspire after Death; or that the perspirable Matter continues to pass off as long as the Body retains any Warmth. This is confirmed by an Experiment of Sir Thomas Browne, in his Pseudodoxica Epidemica, where he tells us, That “upon exactly weighing and strangling a Chicken in the Scales, upon an immediate Ponderation he could discover no sensible Difference in Weight; but suffering it to lie 8 or 10 Hours, till it grew perfectly cold, it weighed most sensibly lighter. The like, says our Author, we attempted and verified in Mice, and performed their Trials in Scales that would turn upon the 8th or 10th part of a Grain.”

    I am, Sir,
     Yours, &c.
    W. B.

NEW DISCOVERIES CONCERNING CANCERS

ADDRESSED TO Charles Bernard, Esq; Serjeant-Surgeon, AND Surgeon in Ordinary, to Her Majesty Queen ANNE

SIR,

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. No. 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,
    Wm. Beckett.

Hatton-Garden,

July 12, 1711.

A Solution of some Curious Problems concerning Cancers

PROBLEM I

Whether the Cancerous Juice is Corrosive, or not

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

Vid. Zacut. de Prax. Med. admirand. Lib. 1. Obs. 15.

Vid Sennert. Paralipom. ad Part. 1 Cap. 19.

Vide Galen. in Aph. Hip. Com. Lib. 6 Aph. 38.

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 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 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.

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 V

Whether 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 VI

Whether 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