Treating Epithelioma With Arsenic (Arsenicum)

Cases of this disease affecting the lip, the tongue, the scrotum (chimney-sweep's cancer), etc., are stated to have been cured by its internal administration; and although Hirtz concludes that all reports of true cancer being cured by arsenic internally are founded on mala fides, or bad diagnosis, yet there is some trustworthy evidence of its relieving cancerous pain in the stomach and in the uterus. Sir C. Locock mentions his own confidence in it, together with cases from his practice, and from that of Brodie and Sir A. Cooper (Lancet, 1837), and Mr. Hunt records a marked instance of relief under small doses frequently repeated, not amounting to more than 10 min. in twenty-four hours. The case was said to be undoubted uterine cancer, and the relief given was greater than from morphia: as a rule, a pill was preferred, containing 1/20 gr. or less. Fordyce Barker also speaks highly of its power to relieve pain and improve the general condition, in doses of about 3 min. of Fowler's solution (American Journal of Obstetrics, November, 1870). Dr. Walshe has written specially to recommend the iodide of arsenic as most valuable (Dublin Quarterly Journal, August, 1857, v., p. 9). I have given Fowler's solution internally in many cases of epithelioma, when the disease was extending rapidly, and have known it apparently retard for a considerable time the progress of the malady, relieve the pain, and improve the general condition. Cases where the lower lip or the scrotum was affected have given me the best results: the dose usually prescribed was 5 min. thrice daily.

Treating Epithelioma With Lime (Calcium)

A mixture of quick-lime (2 parts) and caustic potash (1 part) is sometimes a useful es-charotic for superficial forms of epithelial cancer; it should be mixed, just before using, with sufficient alcohol to form a paste ("Vienna paste"), and spread over a suitable aperture in diachylon plaster previously placed on the part; its action begins immediately, and lasts for about half an hour; the eschar is dark-colored, and separates in from ten to twelve days. A proportion of 6 parts of lime to 5 of potash is recommended by some authors, and for application to deeper-seated parts, such as the neck of the uterus, a combination of 1 part of lime with 2 of potash is used, especially by French surgeons ("caustique Filhos"); it is fused by heat, and poured into a small mould of lead, which can be cut away as the caustic is required.

Treating Epithelioma With Kalium (Potassium)

The disadvantage of the deliquescent character of potash may be obviated, and its efficacy rather increased by combination with caustic lime, two parts of the latter to one of the former constituting "Vienna paste;" it should be kept dry, and moistened only with a little spirit as required. Epithelioma affecting the lip has been sometimes cured by successive applications of this caustic, but it is painful and tedious. The chlorate, given internally and applied locally, has also been said to arrest and cure epithelioma and certain Paris surgeons especially have reported well of the local use of concentrated solutions. I have observed several cases treated in this manner, but without substantial benefit. Uterine Ulceration. - Pure caustic potash has been applied to ulcerations and hyperplasiae of the cervix uteri, and although disastrous results, such as contraction and cicatrix have occasionally followed, it may be of decided service, in skilled hands, not only for irregular ulcerative conditions, but also in chronic cervicitis with induration (areolar hyperplasia); in such cases it may be applied about every ten days for several times, and free injections of vinegar and water should be used afterward. Dr. Henry Bennet recommended it or the lime compound "as a last resource," and the Vienna paste is sometimes serviceable. French surgeons use the same remedy, with an additional quantity of lime, carefully prepared in lead or iron tubes (caustic of Filhos, of Robiquet).

Primary Syphilitic Ulcers, Warts, etc., have been sometimes destroyed by caustic potash. The bichromate is very useful for this purpose.

Urethral Stricture has been treated by the application of caustic potash to the affected part, and in some cases of cartilaginous hardness, and of unusual irritability, it apparently proved useful - with due precautions -but the majority of modern surgeons rightly, I think, object to any direct caustic application in such cases.