We must not, however, rest so strongly on the system just stated, to neglect the sentiments of other authors. It is certainly, as we have said, the more general and the more fashionable opinion that cancers are local complaints. This idea has not, however, been expanded so as to meet all the appearances, unless by U u referring it to putrid or scrofulous tumours, except by the pathologists of the school of Mr. Hunter, who have spoken of diseased, and, more lately, of acquired actions. We purposely omit the opinion of Mr. Adams, which we shall afterwards consider more at length.
If the idea of ' taking on diseased action,' be any thing more than saying that a part is diseased, it has not been explained. If it is no more, it says nothing: a cancerous mamma is a diseased mamma, and of course has taken on diseased action. A new step has, however, been lately added, and a part has been said to acquire new actions. Thus, when nature cannot unite a fracture by a bony callus, she supplies its place by a cartilaginous medium. When the coat of an artery is weakened, a lamina of bone supplies the defect; "and in scirrhous formations or changes, a marked and very extraordinary attempt is very frequently evinced to correct the deranged state of things, by reducing the whole into one insensible and homogeneous mass: and here, at the same time, is afforded the most direct evidence of the disease of cancer arising and depending on simple altered organisation only. The very source and supply of the disease is an assimilation of various and unequal structures, giving rise to dissimilar actions. What then could nature do better (when all her attempts have failed to restore an equilibrium of parts) than what she very often effects, viz. reducing the whole into a bony mass? Here all discordancy of action is at once destroyed, and an attempt at natural cure in scirrhus is clearly evinced, which shuts out the idea of a 'specific virus.' This attempt at natural cure is frequently exemplified in the examinations of true scirrhi, a progressive change into bone being often evident; in many, the centres are completely ossified. Such attempts have been still more succesfully accomplished in the ovaria, these parts having often been found wholly converted into bone by the cancerous action. See Baillie's Morbid Anatomy.
"Confused, therefore, as the cancerous mass may appear, yet more of arrangement would seem to exist than one might at first be aware of. Such would appear to be evinced with respect to the membranous intersections, or septa, most commonly observed in scirrhi; as particularly noticed by Dr. Baillie.
"Query: - In the view of natural cure, may not these septa serve as a surface of extension for bony actions, similar to what we see in the formation of the bones of the head?" Young on Cancers, p. 51, etc.
We have thus selected the author's words, as we were apprehensive of mutilating or misunderstanding his reasoning. According then to this author, if any part is diseased, or, to come nearer the point, if any gland is obstructed so that its usual actions are disturbed, it acquires other actions; chiefly,as it should seem,to supply the deficiency, to obliterate the part, or to restore it to a healthy state.
If we were to examine the changes attributed to these acquired actions in the passage quoted, we should find a more ready mode of explaining them; nor should we require so recondite a foundation, as Mr. Young's fundamental axiom, that' the essence of organic life is immutable.' We should not, however, object to this reasoning, were the terminations of cancer ossifications; or indeed were there any acquired actions which would restore the organisation of the parts, or compensate for its injured functions: on the contrary, by cancer the part is indeed destroyed, but sound parts suffer, and life itself is lost. We perceive, also, no explanation of the phenomena of cancer in this system of acquired actions, and, of course, need not dwell on it. Mr. Young's work is the latest on this subject; but, in the same school we have found nothing more satisfactory. We agree, however, with him, that scrofula and cancer are distinct diseases.
The only other system which it is necessary to notice is that of Mr. Adams, who considers cancers as owing to animals of the hydatid kind. To find them penetrating all the intricate convolutions of minute arteries, is, at first view, a striking objection to this system; yet they appear in the liver, in the ovaria, and other organs, where the access is equally difficult. This subject, of course, we must resume when we speak of this animal, and can only add, that the cause is highly probable; and were the opinion we have offered no longer tenable, we should not hesitate to adopt that of Mr. Adams. A singular case of cancer, strongly corroborative of the disease arising from hydatids, occurs in Dr. Hamilton's Observations on Scrofulous Affections, with Remarks on Scirrhus, etc.
The parts usually affected by cancer are, the mammae of females, the uterus, the testes, the glans penis, the tongue, the stomach, cheeks, lips, and angles of the eyes. These are not always glandular parts; nor, though a cancer of these is a more dangerous disease, though extirpation more seldom succeeds, yet in a depraved state of the fluids, any organ may suffer if a cause of suppuration occurs. The ovaria are said to be affected with cancer: more commonly, however, they become scirrhous; or enlarged by hydatids, forming local encysted dropsy. Of the prostate gland, also, cancer is a rare complaint, though in advanced age this part often becomes scirrhous. The breasts of females are seldom cancerous before the cessation of the menstrual discharge, for whatever may be the appearance, a Milk Abscess Never Becomes A Cancer. We have seen it continue beyond the period of the cessation of the catamenia without any bad consequences: it has healed at last.
It is not easy to say why the parts mentioned should be peculiarly subject to the disease. The cause has been referred to a complicated structure; but there is no such structure in the tongue, in the lips, in the angles of the eyes. The sexual parts are certainly most subject to the complaint. Is it that the circulation is slower; that congestion is more likely to happen; and that any accidental cause of inflammation may excite the action of the obstructed portion ? In every view of the disease the same difficulties will recur.