A SCIRRHUS is a hard indolent tumour seated in some of the glands; as the breasts, the arm-pits, &c. If the tumour becomes large, unequal, of a livid, blackish or leaden colour, and is attended with violent pain, it gets the name of an occult cancer. When the skin is broken, and a sanies or ichorous matter of an abominably foetid smell is discharged from the sore, it is called an open or ulcerated cancer. Persons after the age of 45, particularly women, and those who lead an indolent sedentary life, are most subject to this disease.
CAUSES. - This disease is often owing to suppressed evacuations; hence it proves so frequently fatal to women of a gross habit, particularly old maids and widows, about the time when the menstrual flux ceases. It may likewise be occasioned by excessive fear, grief, anger, religious melancholy , or any of the depressing passions. Hence the unfortunate, the choleric, and those persons who devote themselves to a religious life in convents or monasteries, are often afflicted with it. It may also be occasioned by the long-continued use of food that is too hard of digestion, or of an acrid nature; by barrenness; celibacy; indolence; cold; blows; friction; pressure; or the like. Women often suffer from the last of these by means of their stays, which squeeze and compress their breast so as to occasion great mischlef. Sometimes the disease is owing to an hereditary disposition.
SYMPTOMS. - This disorder seems often very trifling at the beginning. A hard tumour about the size of a hazle nut, or perhaps smaller, is generally the first symptom. This will often continue for a long time without seeming to increase, or giving the patient great uneasiness; but if the constitution be hurt, or the tumour irritated by pressure, or improper treatment of any kind, it begins to extend itself towards the neighbouring parts, by pushing out a kind of roots or limbs. It then gets the name of cancer, from a fancied resemblance between these limbs and the claws of a crab. The colour of the skin begins to change, which is first red, afterwards purple, then bluish, livid, and at last black. The patient complains of heat, with a burning, gnawing, shooting pain. The tumour is very hard, rough, and unequal, with a protuberance, or rising, in the middle; its size increases daily, and the neighbouring veins become thick, knotty, and of a blackish colour.
THE skin at length gives way, and a thin sharp ichor begins to flow, which corrodes the neighbouring parts till it forms a large unsightly ulcer. More occult cancers arise, and communicate with the neighbouring glands. The pain and stench become intolerable; the appetite fails; the strength is exhausted by a continual hectic fever; at last, a violent haemorrhage, or discharge of blood, from some part of the body, with faintings, or convulsion fits, generally put an end to the miserable patient's life.
REGIMEN. - The diet ought to be light, but nourishing. All strong liquors, and high-seasoned or salted provisions, are to be avoided. The patient may take as much exercise as he can easily bear; and should use every method to divert thought, and amuse his fancy. All kinds of external injury are carefully to be guarded against, particularly of the affected part, which ought to be defended from all pressure, and even from the external air, by covering it with fur or soft flannel.
MEDICINE. - This is one of those diseases for which no certain remedy is yet known. Its progress however may sometimes be retarded, and some of its most disagreeable symptoms mitigated by proper applications. One misfortune attending the disease is, that the unhappy patient often conceals it too long. Were proper means used in due time, a cancer might often be cured; but after the disorder has arrived at a certain height, it generally sets all medicine at defiance.
WHEN a scirrhous tumour is first discovered, the patient ought to observe a proper regimen, and to take twice or thrice a-week a dose of the common purging mercurial pill. Some blood may also be let, and the part affected may be gently rubbed twice a-day with a little of the mercurial ointment, and kept warm with fur or flannel. The food must be light, and an English pint of the decoction of woods or sarsaparilla may be drank daily. I have sometimes discussed hard tumours, which had the appearance of beginning cancers, by a course of this kind.
SHOULD the tumour however not yield to this treatment, but, on the contrary, become larger and harder, it will be proper to extirpate it, either by the knife or caustic. Indeed, whenever this can be done with safety, the sooner it is done the better. It can answer no purpose to extirpate a cancer after the constitution is ruined, or the whole mass of humours corrupted by it. This however is the common way, which makes the operation so seldom succeed. Few people will submit to the extirpation till death stares them in the face; whereas, if it were done early, the patient's life would not be endangered by the operation, and it would generally prove a radical cure.
WHEN the cancer is so situated that it cannot be cut off, or if the patient will not submit to the operation, such medicines as will mitigate or relieve the most urgent symptoms may be used. Dr. Home says, that half a grain of the corrosive sublimate of mercury, dissolved in a proper quantity of brandy, and taken night and morning, will often be of service in cancers of the face and nose. He likewise recommends an infusion of the solanum, or nightshade, in cancers of the breasts.
BUT the medicine most in repute at present for this disease is hemlock. Dr. Stork, physician at Vienna, has of late recommended the extract of this plant as very efficacious in cancers of every kind. The Doctor says, he has given some hundred weights of it without ever hurting any body, and often with manifest advantage. He advises the patient however to begin with very small doses, as two or three grains, and to increase the dose gradually till some good effect be perceived, and there to rest without further increase. From two or three grains at first, the Doctor says he has increased the dose to two, three, or four drachms a-day, and finds that such doses may be continued for several weeks without any bad consequences.
THE regimen which the Doctor recommends during the use of the medicine, is to avoid farinaceous substances not fermented, and too acrid aromatics. He says, good wine will not be hurtful to those who are accustomed to it, nor a moderate use of acids; and adds, that the patient should live in a pure free air, and keep his mind as quiet and cheerful as possible.
THE Doctor does not pretend to fix the time in which a cancer may be resolved by the use of hemlock, but says he has given it for above two years in large doses without any apparent benefit; nevertheless the patient has been cured by persisting in the use of it for half a year longer. This is at least encouragement to give it a fair trial. Though we are far from thinking the hemlock merits those extravagant encomiums which the Doctor has bestowed upon it, yet, in a disease which has so long baffled the boasted powers of medicine, we think it ought always to be tried.
THE powder of hemlock is by some preferred to the extract. They are both made of the fresh leaves, and may be used nearly in the same manner. Dr. Nicholson of Berwick says, he gradually increased the dose of the powder from a few grains to half a drachm, and gave near four drachms of it in the day with remarkably good effects. The hemlock may also be used externally either as a poultice or fomentation. The sore may likewise be kept clean by injecting daily a strong decoction of the tops and leaves into it.
FEW things contribute more to the healing of foul sordid ulcers of any kind than keeping them thoroughly clean. This ought never to be neglected. The ideal application for this purpose seems to be the carrot poultice. The root of the common carrot may be grated, and moistened with as much water as will bring it to the consistence of a poultice or cataplasm. This must be applied to the sore, and renewed twice a-day. It generally cleans the sore, eases the pain, and takes away the disagreeable smell, which are objects of no small importance in such a dreadful disorder.
WORT, or an infusion of malt, has been recommended not only as a proper drink, but as a powerful medicine in this disease. It must be frequently made fresh, and the patient may take it at pleasure. Two, three, or even four English pints of it may be drank every day for a considerable time. No benefit can be expected from any medicine in this disease, unless it be persisted in for a long time. It is of too obstinate a nature to be soon removed; and, when it admits of a cure at all, it must be brought about by inducing an almost total change of the habit, which must always be a work of time. Setons or issues in the neighbourhood of the cancer have sornetimes good effects. In a cancer which had set all medicines, and even surgery at defiance, I lately saw remarkable effects from an obstinate perseverance in a course of antiseptics. I ordered the deep ulcers to be washed to the bottom by means of a syringe, twice or thrice a-day, either with an infusion of the bark, or a decoction of carrot, and that the patient should take, four or five times a-day, a glass of good wine with half a drachm of the best powdered bark in it. The sores, after being washed, were likewise sprinkled with the same powder. When the patient began this course, her death was daily expected. She continued if for above two years, with manifest advantage; but being told by an eminent surgeon, that the bark would not cure a cancer, and that the sores ought not to be washed, she discontinued the practice, and died in a few weeks. This course was not intended to cure the cancer, but to prolong the patient's life, which it evidently did almost to a miracle.
WHEN all other medicines fail, recourse must be had to opium, as a kind of solace. This will not indeed cure the disease, but it it will ease the patient's agony, and render life more tolerable while it continues.
TO avoid this dreadful disorder, people ought to use wholesome food; to take sufficient exercise in the open air; to be as easy and cheerful as possible; and carefully to guard against all blows, bruises, and every kind of pressure upon the breasts or other glandular parts. As hemlock is the principal medicine recommended in this disease, we would have given some directions for the gathering and preparing of that plant; but as its different preparations are now kept in the shops, we think it much safer for people to get them there, with proper directions for using them.