Chapter 17 - Surgical Diseases
Modern Surgery
Inflammation
Suppuration and Abscess
Mortification
Pyaemia
Ulceration and Ulcers
Boils
Carbuncle
Malignant Pustule
Burns and Scalds
Frost Bite
Chilblains
Mechanical,Injuries
Septic Wounds
Incised Wounds
Rules for Examining and Dressing Wounds
Antiseptic Dressings
Way Wounds Unite
Punctured Wounds
Lacerated Wounds
Granulation and Scarification
Gunshot Wounds
Poisoned Wounds
Fractures
Way Broken Bones Unite
Dislocations
Different Diseases of Bones
Pereostitis
Necrosis
Coxalgia
White Swelling
Bunions
Whitlow
Stiff Joint
Tumors
Cancer
Polypus
Piles
Wens
Aneurisms
Bronchocele
Water in the Scrotum
Blood in the Scrotum
Phlebitis
Varicose Veins
Hernia
Varicocele
Deformities and Irritations of the Spine
Wry Neck
Foreign Bodies in the Eye
Stye
Inflammation of the Edge of the Eyelids
Disorder of the Lashes
Ptosis
Chronic Inflammation of the Lachrymal Sac
Opthalmia
Inflammation of the Cornea
Inflammation of the Iris
Weakness of Sight
Imperfect Vision
Short and Long Sight
Squinting
Affections of the Ear
Inflammation of the Meatus
Wax in the Ear
Earache
Inflammation of the Tympanum, Deafness
Bleeding from the Nose
Ingrowing Toe Nail
Chafing and Excoriation
Foreign Substances
Bleeding from Wounds
Proud Flesh
Ambrine
Compression of Arteries to Stop the Flow of Blood
Anesthetics
Care of the Teeth
Rotting of the Teeth
Tooth-Ache
Filling Teeth
The First Teeth
Cleaning the Teeth
Ulcer of the Stomach
Glanders
X-Ray
Radium
Trachoma
Arterio-Sclerosis
Flatfoot
Riggs' Disease
Bandages

17.36 Cancer

Cancer.

This belongs to the class of malignant tumors. It has two stages. The first is that of indurations or scirrhus, during which it has, under the finger, the feeling of stony hardness. The second stage is that of ulceration or open cancer.
Cancer most often attacks the female breast, the skin, the mucous membranes, the tongue, the stomach, the neck of the womb, the lips, etc. It rarely occurs in subjects under thirty years of age, and not often in persons under forty five.

The Symptoms of Cancer, when it appears in the breast, are, a puckered condition, and dull, leaden color of the skin; a hard knotty, and uneven fed; and occasionally sharp pains. When it attacks the skin and mucous membranes, there is a hard, warty lump, which ulcerates, after a time, producing an open sore, with a hard base.

The sore of a cancer discharges an irritating, excoriating matter, which has a peculiarly fetid odor, so offensive and so different from any other smell, that it is seldom forgotten. The bones of a cancerous person break with great ease. Unmarried females are much more liable to the disease than the married. The cancerous growth is composed, in part, of cells, rounded or caudate, containing, as seen under the microscope, nuclei younger cells, and granules. (Fig. 176.)

The difference between these cells and those of common pus globules may be seen by comparing Fig. 176 with 177, the latter being pus corpuscles highly magnified by a powerful microscope. Fig. 178 represents pus globules not so much magnified.

Treatment. There are but two methods of treatment which promise any success. The first is to extirpate the tumor by a surgical operation before the disease has so far invaded the constitution as to be sure of returning. The other is that adopted by Dr. J. W. Fell, an American physician, who was permitted to try his remedies in one of the English hospitals, and who drew from the surgeons in charge of it a favorable report of the results.
Dr. Fell's remedies are mainly blood root and chloride of zinc (336) made into a paste. The skin over the tumor is first destroyed, and this paste, spread upon strips of linen, is applied. This causes an eschar, into which incisions are made, half an inch apart, taking care to avoid the living tissue. The same paste spread in a like manner is then daily inserted into the furrows. By this means, which is original with Dr. Fell, the effect of the caustic penetrates through all parts of the tumor, causing the whole diseased mass to fall off, and leave a healthy, granulating surface.
In incipient cancer, where the disease has not made much progress, Dr. Fell uses the above, which he calls a brown ointment (336), and in connection with it an ointment of the iodide of lead (387), using each twelve hours. With these, he claims that he cures incipient cancers with great readiness. He also employs, internally, half grain doses of pulverized blood root (143), with arsenic and cicuta.
Dr. Fell claims that with these preparations, he has often cured lupus, and has been very successful with them in treating indolent ulcers. Of late a new treatment has sprung up namely, the injection of anti cancer serum, but as yet a definite opinion cannot be given as to its results. the latest remedy that holds out any hope is in the use of the x ray, Finsin light, or radium. The action of this agency will be explained at the end of this chapter. It is not possible that they can be successful in deep seated cancers at the present state of their usefulness, and it may be said that the hopes that were at first held out for them, together with the anti cancer serum are not being fulfilled; but their success has been brilliant in certain varieties, especially skin cancers and lupus.

Soft Cancer. Bleeding Cancer.
Medullary Cancer. Encephaloid Tumor. Fungus Hematodes.

This varies in size from that of a nutmeg to a child's head. Its color varies from white to deep red. At times it is soft and elastic at first; at other times, it is firm and tense. The patient is wan and pale from the beginning. The parts do not ulcerate, as in scirrhus; but after the skin is broken, a spongy, bleeding tumor protrudes.

Treatment. Dr. Fell's method.

Black Cancer. Melanosis.
This is an organic disease, in which the tissue of the disordered part is converted into a black, hard substance, which is converted into ulcerous cavities. This often appears in the lungs, and is met with in the liver and other parts.
Its symptoms are, a sallow complexion, great debility, and dropsical swelling of the limbs before the termination.

Treatment. When it appears externally, Dr. Fell's treatment is worth a trial. When in the lungs, the inhalation of tincture of bloodroot and solution of chloride ~of soda (241) should be used. Two teaspoonfuls may be put in a Vapor Inhaler, the instrument being filled half full of hot water, and inhaled ten minutes, three times a day; the blood root pills (143) being taken at the same time.

Fatty Tumor. L'poma.
This is the most common of all the forms of tumor. These bodies generally have a soft and doughy feel, or as if filled with wool. They are the least inclined to become malignant, and consequently the least dangerous, of all the tumors. Whatever pain there is, is caused by their size, weight, and pressure. They are occasionally found a little below the point of the shoulder, in the deltoid muscle of females, and are caused by the unreasonable pressure of the dress at that point.

Treatment. They should be removed by an operation, which is easily performed, as they separate very readily from surrounding parts, shelling out of the capsule that surrounds the tumor like an egg from its shell.

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