By Dr. H. HENDERSON PATRICK, Glasgow. MR. CHAIRMAN, LADIES AND GENTLEMEN,
How to tackle the scourge of cancer is, without doubt, the most urgent problem which confronts the medical profession at the present time. For that reason, although this paper may not bring us much nearer the correct solution of the problem, I make no apology for introducing the subject. If I can afford you food for thought or matter for profitable discussion, or if I can enable some to view this subject from a new standpoint, the object of my discourse will be amply fulfilled.
The history of cancer I shall pass over. It was most ably and fully dealt with by our esteemed President, Dr. George Burford, in paper which he read at our Annual Congress in 1924. Suffice to say here that cancer is a disease of great antiquity, writings on the subject being traced back to 1500 B.C., and that there is no reason to suppose that during all those years the features of the disease have altered in any way.
Throughout those centuries the most astute brains in the medical profession have been endeavoring to discover the aetiology of and cure for this disease, and, during recent times at least, ample funds have been available for investigation (except, unfortunately, in homoeopathic circles), and yet no definite answers to the many questions with which the problem bristles have been forthcoming. Of theories there have been many, yet none has been supported by sufficient evidence to make it acceptable to the profession as a whole.
Let us refresh our memories regarding some of the generally accepted facts on the subject. The cancer growth consists of a mass of cells which, in appearance, are indistinguishable from the normal cells of the body. The cells may be of different types, but there is no type which is not normally found in the organism. They perform no useful function. They are not organized in any way, they seem to have one direction of function and one only, and that, proliferation. This has been described, very aptly I think, as an insanity of the tissue. The cells infiltrate the surrounding tissues, not through any special motor power which they possess, but entirely through mutual pressure due to their own multiplication, and their distribution takes the line of least resistance. They may enter the lymphatic channel or the blood-stream and so may reach adjacent or distant parts, carrying with them their power of proliferation.
In their new environment the same process is repeated, until, through time, by their parasitic action, their host is gradually destroyed. Since the masses of cells have no organization, the individual cells are easily killed, giving rise to neurotic areas, and ulceration often occurs. In these cases, septic poisoning or haemorrhage may be the immediate cause of death. The first evidence of the disease is always local. It begins in tissues which are, at the time, in a state of growth, or may be under repair, e.g., carcinoma, the more common form of malignant growth, originates in the epithelial or endothelial tissues, where throughout the whole of life a certain amount of tissue repair is normally in progress. Sarcoma, on the other hand, arises from the tissues derived from the embryonic mesoblast and is common only during the time of life when these tissues are in a state of growth.
Now, what is it that transforms this normal body cell into the cancer cell, into this insane cell which has lost all sense of co-ordination and seems to have only one property left, that of proliferation? All the writers on this subject seem to me to have the idea that the cancer cell has taken on some new life, has acquired some new ungovernable property which it did not previously possess. Is not this a wrong point of view? This power of reproduction is an intrinsic part of every cell during some part of the life of the organism as a potential element of many cells throughout the entire life of the organism.
During embryonic life cell proliferation must take place at a truly remarkable rate. When we recollect that the child at birth, the placenta, &c., have all developed in the short space of nine months from a single fertilized ovum, we must realize that the rate of cell proliferation is one with which few malignant growths could complete. Wherein lies the difference? The one is cell multiplication under guidance, and the other the same thing without any control.
Now, this “guidance” is a very wonderful thing. The fertilized ovum splits up into cells which soon become changed into various different kinds. There is continued growth and differentiation until all the various kinds of cells found in the body have been formed, after which cells, for the most part, produce their own kind only. The rate of growth of the various types of cell varies tremendously at different periods of the antenatal life. This guiding control, therefore, commands not only the type of growth, but also the rate of cell proliferation, increasing or decreasing it according to the needs of the organism.
What is this controlling influence? I doubt very much if mortal man will ever know. It is of the very essence of our spiritual existence. This cell control continues, also, throughout the entire life of the individual. We see it, for instance, in the repair of surface abrasion. The epithelial cells proliferate until the abrasion is healed and then proliferation stops. The control is still functioning. We see, then, that this power of reproduction is present in every cell during the period of growth, and in many cells, e.g., epithelial and endothelial, during the entire life of the individual.
Now I wish to suggest to you that the transition from the normal cell to the malignant is not due to any increased power which the cell has acquired, but is due to the breaking, for some reason, of that control under which all cells live and function, giving vent to that potential malignancy which is present in every cell. The earlier in the life of the individual the control is broken, the more potent is the latent power in the cell, hence the younger the victim of this disease, the more malignant, as a rule, is the growth.
Although it is highly improbable that we shall ever know the inner workings of the cell control, there is no reason, why, through time, we should not be able to tell with considerable accuracy the factors which lead to the severance of the bond between the cell and the higher influence. One factor is now fairly generally recognized, viz., the factor of local irritation. Evidence of this is found in chimney sweep’s cancer, cancer of the lip in clay-pipe smokers (probably due to heat), cancer of the tongue starting at the site of tooth irritation, cancer arising from continued exposure to X-rays. The common sites of cancer in the gastro-intestinal tract are just those parts where we would expect irritation to be most in evidence. Many other clinical examples might be given. In addition, we have the artificial production in animals of tumours very similar to cancer by local irritation. Taken altogether, the evidence that continued local irritation plays an important part in the breaking of the cell-controlling power is almost irresistible.
The ordinary effect of temporary local irritation is to stimulate the tissues to repair the damage done by the irritant. The higher control is slackened, the cells proliferate, and the repair is made good. If the irritation is continued the cell proliferation is continuous, the control is slackened to its utmost capacity and ultimately snaps. I use that expression as the nearest simile I can think of is that of an elastic band which will stretch so far and no further. Local irritation may be due, of course, to a great variety of causes. In addition to the examples already given, I would mention irritation surrounding long-standing simple ulceration; excessive stimulation following continued abuse of condiments, alcohol or drugs; chronic catarrh, e.g., of the cervix, uteri.
I think we may take it that local irritation, in one form or another, is the principal exciting factor in the breaking of this cell control. Local irritation, however, will not explain the incidence of cancer as we find it to-day. It does not explain the rapid increase in the death-rate from cancer within comparatively recent years. It does not explain why cancer is a disease affecting, more particularly, highly civilized countries. There must be obviously some predisposing cause or causes. I think one of the causes, at least, will be found in what I shall call, for want of a better term, general irritation. By general irritation I mean mental strain of various kinds. If you will go carefully into the history of your cases of cancer, you will find, in the vast majority of them, a history of mental strain, usually mental anxiety. That, at least, has been my experience. This mental strain is, in females, very often anxiety regarding friends or relatives, and, in the case of males, financial worries. Excess of work may also produce this suitable soil, but is much less likely to if it is not associated with worry.
In this “general irritation” I think you will find the chief predisposing factor in the aetiology of this much dreaded disease. Taking life as a whole, there can be little doubt that the “pace,” if I may use the expression, is much faster than it was a generation ago, sufficiently so, probably, to account for the increased death-rate from this particular trouble.
Statistics are frequently misleading and unreliable, but some significance must surely be attached to the fact that, among the clergy, who at least ought to take a more calm and philosophical view of life than the average, the mortality figure from cancer is 45, against the average of 78.
If the foregoing thesis is at all accurate, it would be only natural to assume that the greater the “general irritation” or strain in any individual, the less local irritation would be required to break the cell control, and vice versa.
If we are right regarding these aetiological factors, then the prophylactic treatment is obvious. Remove all possible causes of local irritation, and “Don’t worry.” Probably the “Don’t worry should come first as being the more important.
In the treatment of the patient suffering from carcinoma it is of the greatest importance that, so far as is possible, he or she should be put, mentally, at rest. That is a task which will tax the ingenuity of the best of physicians. I shall not, therefore, presume to advise you how best to do it, but if it can be managed much will have been gained.
One of the first things which the physician has to decide is the question of surgical treatment. I hope the surgeons present will pardon my putting it that way, but I think the homoeopathic physician has usually to decide this question, after taking very fully into consideration, of course, the views of his surgical colleague. This question, in the past, has been one of great difficulty to me. Holding the views which I have endeavoured to express to you, however, I am now rarely in doubt. If there is a good or reasonable chance of removing the whole of the malignant growth, I advise operation. If the operation is successful from the point of view of removing all the new growth, I do not imagine the patient is cured. He has got a reprieve, the immediate danger is removed, and it is now the duty of the physician to deal with the predisposing cause. In those cases where the patient remains free for some years and again falls a victim to the disease, I do not think it is a recurrence, but that the condition has started again de novo.
Surgical treatment is often necessary as a palliative measure, most commonly in cases of intestinal obstruction. In cases of doubtful carcinoma of the gastro-intestinal tract I never allow my patients to be X-rayed, as I am quiets satisfied that, in a certain percentage of cases, exposure to X-rays gives rise to a marked increase in the malignancy of the growth.
The medical treatment of cancer differs in no way from the medicinal treatment of any other disease. The totality of the symptoms of the patient, and that only, can offer any reliable guide as to what medicine to select. The real trouble regarding the medical treatment of this disease is that, so often, the symptoms are vague of the growth itself, sometimes absent altogether. The absence of symptoms is not, however, surprising, as the proliferating cells, being part of the body itself, do not give rise to any toxins and there is, therefore, nothing for the body to react to.
What are we do for those patients who have no symptoms, who present no drug picture that we can prescribe on?
From the standpoint of homeopathic philosophy, the patient who is seriously ill and presents no symptoms is incurable. Shall we wait, then, for symptoms to turn up? If so, we shall probably wait until there is an ulcerated surface and we get symptoms of toxaemia. A prescription based on these symptoms will relieve the toxaemia, but will probably do nothing towards stopping the growth.
Some years ago a patient was admitted to the Holds worth Homoeopathic Hospital on account of carcinoma of the cervix uteri. She had been attending the Dispensary for some months previously, and had been slowly but definitely slipping backwards. The surgeon who examined her thought he could get the growth completely away, and, although it seemed rather a doubtful case, operation was decided upon. At the operation a preliminary curetting was done and the uterus disinfected as far as possible, prior to abdominal hysterectomy. On opening the abdomen nodules were founds in the wall of the bladder. The abdomen was, therefore, closed nothing being removed.
Shortly after the operation the patient developed a profuse greenish yellow vaginal discharge having a most offensive odour, while her general condition was so bad that it looked as if she might die within a few days. At that time some articles were appearing in the Homoeopathic World on black gunpowder, and, with the idea of trying to clear up the odour, which was very disturbing to the other patients in the ward, I decided to try gunpowder. The third centissimal potency was given. In a very short time there was marked improvement, the odour disappeared, the patient’s colour improved, her appetite came back, the vaginal discharge stopped, and, to cut the story short, she went out of the hospital, after six weeks, apparently well. The surgeon again examined her and reported that, had he been seeing her for the first time, he could not have made a diagnosis-he could feel nothing abnormal in the cervix or the broad ligaments. I regret to say that after about ten months this patient had a recurrence and that she died about eighteen months after leaving hospital.
The ultimate result notwithstanding, this case was very striking, and there could be no doubt about the temporary effect of the gunpowder. This led me to try other two combinations: the first was sulphur, carbo veg., and carbo animals, the second sulphur, silica, and carbo veg. I got Nelson & Co. to triturate these substances together from the crude to the sixth centessimal potency.
It is far too early yet to make any claim for these combinations. All I wish to say is that I am more satisfied with the results of the second one-sulphur, silica, and carbo veg.- that with anything else I have tried.
Now, in case I should be misunderstood, I would like to say quite definitely that I am not advocating the use of this combination in all cases of cancer. In every case an effort should be made to get symptoms on which to base a prescription. If the symptoms are there, then the medicine which they call for must be given. If nothing can be found on which to prescribe, I have found this combination very useful.
Whatever remedy is chosen, I think it should be repeated frequently and given in what is now called the ” ” method. Reaction is always sluggish, and the effect of a single dose soon passes off.
In conclusion, let me say that, while it is impossible to look on cancer otherwise than as one of the most serious conditions with which we have to deal, I do not approach these cases now with the same feeling of helplessness as at one time I was wont to do.
Dr. CLARKE said all would agree that Dr. Patrick’s paper was something rather outside the usual. He had given, to the speaker at any rate, a clearer conception of the cancer process than he had formed before. The process was one of proliferation without control. Members of the Congress had heard something the previous evening from Sir Frederick Feeble about the control of cell production, but Dr. Patrick’s very clear exposition that control was the feature was something which he (Dr. Clarke), at any rate, had not come across before-especially in the illustration of the fertilized cell in gestation. He was glad to hear that Dr. Patrick had used his old friend, black gunpowder. It was an extremely powerful remedy. Personally, he looked upon it as a unit. It was something more than a combination, and he believed that in the manufacture of the powder there was an element of graphites, which was used for keeping the grains separate. It was no invention of his own. He had merely put it into a shape so that it could find its way into the homoeopathic materia medica; and there it was in the appendix to his Dictionary. In ancient days it had been the remedy by which Jack Tar and Tommy Atkins had cured their gonorrhoeas and their chancres, and they had done much better on that than they had on the things which the doctors had given them.
Dr. COOPER said there was one thing about Dr. Patrick’s paper which had rather astonished him, and that was the remark that Dr. Patrick did not think that the action of single dose lasted long in cases of cancer. Personally be had found that the dose more often than in other cases. He considered that a great deal depended upon the frequency with which single doses were repeated as to the benefit which was obtained from them. If they were repeated too often one sometimes got an over-stimulation, and an unfortunate result might follow. He could not agree with Dr. Patrick in saying that the action did not go on for a very considerable time in some cases. Dr. Patrick had mentioned the question of surgery-the removal of the tumour- and had said that he was in favour of removing it in every case where it was possible to do so. He, personally had made it clear in his own paper that he was of the opinion that one wanted to get control over the constitutional condition first before removing under much more safe conditions.
Dr. Patrick had laid stress, in one case especially, on the necessity for operation in intestinal obstruction. Personally he had found frequently, in cases of intestinal obstruction or malignant growth, that when the indicated remedy was given the obstruction suddenly disappeared in the most astounding way. A case he had had many years ago had been one in which it had been said by the surgeon who had examined the patient that one could not get a straw through, the patient was so blocked up. He himself had been called in, and the question was one of operation. He had been told that something had to be done because the patient’s bowels were absolutely stopped up, and it seemed that he would die from obstruction. He advised, however, an interval of a few days in order to see what the giving of a dose would do. He had been asked if he would take the responsibility and he had accepted the responsibility. and he had accepted the responsibility. He had given the patient a dose of, he thought he remembered it was, ruta, and the patient had immediately had what he called a normal action. The family were so astonished that they could not make out what had happened. Although he had not got the patient well, the surgeon had said that he did not understand how such a thing had happened with a man in the condition that a straw could not be got through. He had replied that it was only acting through Nature’s powers. With regard to the effect of mental influence and irritation, irritation formed a site for the development of abscess. Mental effects, effects of diet and of constitution, were all contributory causes to the lowering of the vitality and the resistance of the system to some infection or some micro- organism, which naturally attacked the system when it was debilitated in those particular ways. Articles of diet, such as tea, white bread, and so on, were all contributory causes, but none of them were definite specific causes of cancer. He though himself it was a micro-organism and that that micro-organism got a chance of attacking some people and not others.
Dr. BURFORD said he desired to draw special attention to Dr. Schlegel’s book. Personally he was acquainted with every book which had been written on cancer from the standpoint of homoeopathy and also from the other school’s point of view, but he knew of no book, or of any combination of books, dealing with the actual practical facts of cancer and how to combat it, which would bear any comparison with Dr. Schlegel’s which was the finest work he had come across. It was most informing; it was full of details of actually cured cases; the diagnoses were set forth in it, and it contained the most complete information. The only objection he had to it was that all the cases mentioned in it and been, without exception, cured. All the cases-good, bad and doubtful-which one came across in private and general practice had their counterpart in Dr. Schlegel’s book. Personally he would make it his duty, when the Congress was over, to find some wealthy philanthropist to do for Dr. Schlegel’s book what Mr. Stuart had done for Dr. Haehl’s book.