"That Cancer runs in families, says Dr. "Watson, is well understood, even by the public. An example of this hereditary disposition has just occurred to me in practice. A patient of mine, a barrister, forty-eight years old, has sunk under scirrhus disease involving the momentum, and extending into all the folds of the peritoneum. This gentleman's mother died of malignant disease of the leg, where it commenced as a small wart. Her brother died of Cancer of the lungs, which penetrated the breast-bone, and sprouted out upon the chest. And this brother's wife, who was his cousin also, fell a victim to some sort of Cancer."

Cancer of the breast. Scirrhus generally commences as a hard, circumscribed, moveable swelling in some part of the breast. In its early stages it is not often tender or painful. After a few weeks, or months, however, it becomes affected with paroxysms of violent lancinating pain, which are most apt to occur about the period of menstruation. Not unfrequently a little bloody fluid is discharged from the nipple. The cellular tissue and fat about the gland often become wasted, so that the diseased breast is smaller than the sound one, and the nipple is generally drawn in, and the skin around it puckered. After a time, ulceration commences.

In some few cases the whole of the diseased growth has sloughed out, and a permanent cure has followed.

Medullary Sarcoma of the breast is generally combined with more or less Scirrhus, and rarely exists alone. It forms a large, rapidly-increasing tumour. This affection may be distinguished from Scirrhus by its more rapid growth and greater softness. It is often difficult in its early stage to distinguish it from innocent chronic tumours.


The general rules for the treatment of malignant disease are these: 1st. If the case be decided, any palpable disorder in the health should first be removed, by alteratives and tonics, and then the disease be extirpated as soon as possible, provided it can be done with safety. 2nd. If the case is doubtful, an alterative plan of treatment must be pursued, which will cure the disease if it is really not malignant, and retard its progress if it be. 3rd. If the case is decidedly malignant, but extirpation is deemed impossible or unjustifiable, the rule is the same; the health must be improved, and the disease as much as possible retarded.

Extirpation, however, will not always effect a cure. In ninety-nine cases out of a hundred the disease returns; but the period of its return varies from six months to two or three years, or even longer. The interval may be one of health and hope; and even when the disease reappears, it does not in general return in a character of such formidable suffering as it presents in its first attack.

Arsenic and the Chloride of Zinc have been used in some cases for the extirpation of malignant tumours instead of the knife; and in some cases of flat, superficial, cancerous affections of the skin they may be useful.

If the patient is young and plethoric, and the fits of pain are frequent, and accompanied with heat and throbbing, the diet should be reduced, the bowels be freely opened, and leeches should be applied. Frequent leeching is recommended in the early stages of any malignant disease; but it must not be carried to such an extent as to weaken the patient.

Change of air, freedom from anxiety, a diet that will support the strength without heating the system; wine in moderation, if the patient is weak, and is accustomed to it; and narcotics in sufficient quantities to allay pain.

Sir Thomas Watson says: Great mental distress has been assigned as influential in hastening the development of cancerous disease, in persons already predisposed to it. In my long life of experience, I have so often noticed this sequence, that I cannot but think the imputation true. The body weakened, and its vitality lowered by the worry of the mind, falls for that reason an easier and an earlier prey to the invading disease.

The patient may take any of the preparations of Iron recommended under the head of Consumption.

Dr. F. A. Burrell has published a case of apparent cure of ulcerated scirrhus cancer of the breast: It was for months treated with an external application of a watery solution of Carbolic Acid and Glycerine, without arresting its progress; but it began to diminish in size, and soon cicatrized after the internal use of Carbolic Acid and Sulphate of Quinine was added to the treatment. Two grains of Sulphate of Quinine and a grain and a half of Carbolic Acid were taken three times a day in a little water.

To abate pain and produce sleep the patient may take such sedatives as she finds best agree with her: Extract of Poppies or Extract of Henbane in five grain doses; Laudanum in 25 or 30 minim doses, Opium in half grain or grain doses; Bromide of Potash in ten or fifteen grain doses; or Hydrate of Chloral.

Mr. Weeden Cooke, Surgeon to the London Cancer Hospital, has published a number of cases illustrative of its beneficial effects in allaying pain and producing sleep. The following are some of them.

Case 2

In a case of advanced Cancer of the womb, attended with much acute suffering, especially in the back, twenty grains of the Hydrate of Chloral always produce a comfortable night's rest and no morning sickness. Case 3. - A bad case of Epithelioma of the ear, extending to the scalp, attended with much pain, and the patient is subject to frequent attacks of Gout. Ten grains of Hydrate of Chloral given three times a day. By this he is made perfectly comfortable; there is no sickness; he takes his food well, and his Gout has subsided. Case 4. - A very bad case of Epithelioma of cheek, with perforation, attended with much pain and difficulty in taking food. Sleeps well with twenty grains of Chloral. No morning sickness; appetite good. Case 5. - I was recently called to see a very anaemic lady suffering from sloughing Cancer of the right breast, attended with much sickness and severe pain-apparently dying. She has been restored to comfort and appetite by ten grains of Chloral with five minims of Prussic Acid three times a day. Case 6. - A most painful case of Psoriasis of the lip and fauces, the mucous membrane being quite destroyed, leaving a raw surface; a long time under treatment by various surgeons, relieved entirely from pain by ten grains of Chloral three times a day, enabling the patient to take food comfortably, which had not been the case for a long time. Case 7. - A bad case of Cancer of the tongue; great pain and inconvenience in taking food. Much relieved, and the facility of taking food greatly increased by ten grains of Chloral three times a day. Sleeps well since taking the Chloral. Case 8. - Another case of Uterine cancer with great pain in back is made comfortable by ten grains of Chloral three times a day." "Tincture of Orange Peel in water covers the rather nauseous taste very effectually."

In order to allay the local irritation after ulceration has commenced, poultices of bread or boiled carrots may be used. Also lotions of a weak solution of Chloride of Soda, or a weak solution of Carbolic Acid or Permanganate of Potash. Finely powdered Charcoal or precipitated Carbonate of Iron are useful additions to the poultices, to counteract the unpleasant smell. The following quantities will be found good proportions to commence with, and they may be made stronger or weaker as may be found necessary. They may be applied with a piece of soft sponge:

Permanganate of Potash.............Half an Ounce.

Water, sufficient to make a..........Pint.


Pure Carbolic Acid...................Seventy-six Grains.

Water. ...................................One Pint.


Liquid Carbolic Acid.................A Dram and a Half.

Water.....................................One Pint.

These may be used three times a day, or oftener if found beneficial. Some practitioners have had an idea that Cancer was to some extent connected with Consumption; that they both owed their origin to the same state of constitution. "But in 104 trustworthy narratives, including his own experience, of persons cut off by Cancer, Dr. Walshe found seven only in which the anatomical character of Phthisis was present."

Dr. Holden, of Newark, in New Jersey, after 23 years' experience in one of the largest American insurance offices, entirely dissents from any ideas of identity or similarity between the two affections.

He gives the following strong statistical justification of his opinion.

Among 7030 persons above 40 years of age-and more than half of them above 45,-there were 99 cases of Cancer.

Of the same 7030,1032 had Consumption in their own immediate families, in their parents, brothers or sisters. Among these only eleven cases of Cancer had ever occurred.

If the two sets were only equally liable to Cancer, the odd 5998 persons ought, according to the foregoing ratio, to have numbered among them nearly 64 cases of Cancer. They actually numbered 88.

Again, of 55 deaths occurring in 821 families tainted with Consumption, one only was occasioned by Cancer, 33 by Consumption. Still further, of 1000 deaths from diseases of the bowels and their appendages, there were 13 from Cancer, and in but one of the families of these had Consumption occurred, save one having both Cancer and Consumption.

Dr. Peter Hood published in the London Lancet of October 12th, 1867, a case of cancerous tumour of the breast, which entirely separated, leaving a raw, granulating surface, this result being attributed by the patient to the internal use of small quantities of Lime from the inner surface of oyster shells. This she had taken in consequence of hearing of a case which had been cured by the same treatment. The modus operandi suggested is that ossification of the arteries of the tumour occurs, whereby its nutrition is cut off, and its death ensues. This mode of treatment it is suggested is most likely to be of use in the slowly growing tumours of persons of advanced age. Previously to scraping out the "small white" part of the interior, the shells require baking for three nights in a slow oven, and the dose recommended is as much as will lie on a shilling (English), once or twice a day.