An Account of a Book

IX. An Account of a Book, Recherches sur la Nature & la Guerison des Cancers. Par Mr Deshayes Geudron Docteur en Medicine de l'Universite de Montpellier. A Paris 1700. in 8o. The Ancients in their Divisions of Tumours, confounded Cancers with all other hard and painful Swellings. These they imagin'd to proceed from an Aduft Atrabilarious Blood, which opinion they founded on their Exteriour Appearances, their Black or Livid Colour, and Burning Acrimony. The Moderns changing the terms, derive them from a certain Acid Ferment, which first coagulates the Juices in the Glands, and after corrodes and ulcerates the part. These accounts do not content Mr Geudron, who believes his Observations have furnished him with a more satisfactory Idea of the Formation of Cancers, their difference from schirrous, scrophulous, and other like Tumours, and a more sure Prognostick and Cure. There is so great a diversity in Cancers, he pretends it is impossible to give one common Definition which shall agree to all. Some have a round, unequal, livid, painful hardness; others are flat without lividity, and sometimes indolent. This variety proceeds chiefly from their rise and progress, and the structure of the parts in which they are seated, as the Breast, Womb, Mouth, Nose, Eyes, Ears; all which differ in their appearances. In the year 1690 a Domestick of the Marquis de N. coming to the Author with a hardness on the Forehead, which was ulcerated, very painful and rebellious: He several times cicatrized it, but all in vain; after some time it broke forth afresh. At length, applying a stronger Caustick than before, and impatient to remove the Escarr, stirring it to and fro with his Probe placed on its Center, he perceived several white Filaments in the Interstice between it and the Flesh, which with the Probe he found were hard. Then pulling away the Escarr with his Forceps, the strings came with it, not without a great deal of pain to the Patient. Some of these sprang from the side of the Nose, Eyes, others from the upper part of the Forehead; and when it was separated, they seem'd like the strings at the Root of an Onyon or Leek. This was the occasion which suggested to M. Geudron his first suspicion of the common Doctrine, which ascribes these Maladies to Acids in the Blood. This Incident encourag'd him to make a further Enquiry; and having disfected many Cancerous Tumours, for these eight years past, he gives us these particulars, as the result of his Observations. Cancers are always seated in Glandulous and Nervous parts, and places where there are Lymphatick and Excretory Vessels. There is ever found in them a hard callous substance, not unlike a Horn, with Blood-vessels disseminated thro it, which nevertheless are lesser and straighter than before the formation of the hardness. In Cancrosities of the skin there is the same callous substance, but it expands itself in a very different manner, appearing at first like a plain hard Ulcer, or a small Wart with Cancrous Filaments. These, when the Ulceration has made some progress, appear like the heads of pins in the flesh, and are no other than the extremities of the strings. This substance, always found in true Cancers, this Gentleman thinks is the Cancer itself, which is formed out of the Glands, Lymphatick and Excretory Vessels. These by some accident or other becoming impervious, and ceasing to filtrate and convey their Liquors, by degrees degenerate into a compact horny mass, capable of Germinating and Ulceration. Some, observing the good habit of Body not to be prejudiced by Cancers arising, and after they have been removed the party has enjoyed a perfect health, have thought the part only suffers. Others, seeing that notwithstanding they have been apparently consumed and extirpated, they have broke out with greater violence, have concluded this effect to proceed from some corrosive Acid still remaining behind, and no good to be hoped for till this malignant Ferment be entirely extinguished. This latter opinion does not agree with Mr Gendron's Theory. If such an Acid have an existence, where is it lodged? not in the Blood, for Cancers often arise suddenly from some exterior hurt, blow or compression, often happen to persons in perfect health; to women with a regular evacuation of their Menses. Not in the part, from an effusion of Lympha there, for these sort of Tumours are easily resolved, and except sometimes in the Breast, rarely or never become Cancerous. A thousand Observations shew Cancers in the Skin, on the Nose, &c. have followed upon cutting off a Wart. These are often without pain and inflammation, and the humour will not change Turnsole. Is it not more likely these proceed from some Miliary Gland of the Skin, torn from its seat by the divulsion of the Tendinous Fibres which connected it, than from any Imaginary Acid. As for the Growth of Carcinomatous Tumours, our Author thinks, being composed of the Extremities of Tendinous Fibres, their Vegetation may be explained by the conveying a Nutritious Juice, in the same manner ner as Horns and Nails, and other like substances. The pain proceeds from the compression of the Nervous parts, as that in Corns, which when anything happens to pinch them, is very acute, and the lividity from an obstruction of the progress of the Blood. If the discoloration was the effect of any Caustic Salt, an Escarr would soon ensue, but the blackness of the Cancers lasts many years. It is more reasonable than to think the difficulty the Blood finds in its passage, makes it stop in some places, where losing its fluidity, and becoming thick, it makes the skin which covers the Cancer appear black and livid; and this blackness is observed round the Horns of Animals at their first eruption. The Ulceration proceeds either from the bursting of the Teguments by the increasing swelling, or their excretion, by the corruption of the stagnating Blood. But their incurability arises from an indisposition of the Fibres of the Skin, to unite themselves with the Cancerous Lump. From this account it is plain Schirrosities, Strume, which consist of Liquors stopt by their Viscosity, or coagulated by any Acid, and Polypus, where the Veins keep their order and distribution, are essentially different from these carcinomatous swellings, but when the structure of the Veins is once destroyed, and they degenerate into a hard indissoluble lump, capable of shooting out, they lose their former nature, and become Cancerous. Having thus presented you with his Idea of the Nature and Causes of Cancers, he proceeds to the Prognostick and Cure. True Cancers he affirms are seldom extirpated with success, and the operation would be less in repute, if Strume, schirrous, and other Tumours were not frequently mistaken for them. Mr Gendron only thinks those can be extirpated, whose Basis ends at once, and which do not send strings to the neigh- bouring parts. He laughs at the Precept so often inculcated, to suffer the part to bleed freely to discharge the remains of malignity, recommending instead of this his own practice, to apply Plagiots, with some Arsenical Caustick, and timely to pull away the Escarr with the Cancrous strings, which being harder than the flesh, are not presently divided by the Suppuration. Paracelsus and Vanhelmont his Disciple, boast very much, says he, of their Arsenical Preparations, and other Mineral Absorbents. These indeed may consume the fungous flesh, but the Cure consists only in eradicating the callous body, which is irritated, and produces itself strangely on the injudicious application of sharp and corrosive Medicines. In the year 1692, the Author cured Madam de N. of a cancerous Epulis. The Excrescence first rose in form of a Button of Flesh, from the Alveolus of one of the Dentes-morales of the upper Jaw, which had been pulled out. This in some years was grown as big as a Goose Egg, was hard, unequal, livid, painful, and ulcerated with reddish putrid Serosities coming from it. Finding by his Rules the cancrocity not to extend behind its middle, he pricks the upper part with a sort of Trocar, carefully avoiding the cancerated part, puts in his Escarotick Troches, and stops the whole with a Sponge. Thus the Blood Vessels and Nerves within twenty four hours being cauterized, the Mass began to wither, and lose its sense; he could cut off great parcels without pain, and after the separation the rest was cured in few days. To shew how necessary dexterity is in an Operator, he relates another remarkable case. M. de V. receiving a blow with the Branch of a Tree on the upper lid of his Left-eye, had a hard callous and painful Excrescence: there was a necessity to cut it out, or consume it with Causticks. The first first was impracticable, the latter not without danger. In this difficulty, finding the cancrocity only superficial, and nothing more to be done but to consume it, without hurting the Globe of the Eye, he contrives to blow Leaves of Gold between this and the Excrecence, which, adjusting themselves to the Eye, might cover it from the impression of the Salts. The Invention succeeded, the Tumour was happily consumed, and the part cicatrized. M Gendron thinks the * famous Aphorism of Hippocrates to be best explain'd by his Hypothesis. He thinks it exactly true of such Cancers which have filaments, that lie concealed in the Neighbouring parts. The attempting a perfect Cure of these by the Knife, Cautery or Escarticks, does only irritate and redouble their progress, and creates horrible ulcerations and pains, and often puts an untimely end to the Patients life, which by palliation might be prolonged. Here he commends the wise conduct of the Abbot Gendron his Uncle, to the Queen Mother of France, Ann of Austria. The topicks he commends for palliation are chiefly these, Bella Donna or Solanum Lethale. This was the Secret of Percival Willughby, and very much recommended by the Abbot his Uncle; but if too long continued is prejudicial. To the juice of the Plants he adds Saccharum Saturni. The second famous Application is the Bags of the said Abbot, made of a porous Stone found in la Beausse, calcined, and several times extinguished in Vinegar. This he has much improved by incorporating with the other Ingredients the Metallick Sulphurs of Iron, Copper and Lead. The rest contains nothing particular, and so we shall not repeat it here. The Author promises he will one day give the Publick his observations, to confirm his Theory. He tells further, he had a design to add the History of some diseases of the Eyes, but thinking this more proper for a History of the Diseases of the Five Senses, which he intends to write, he defers it till that shall see the Light. FINIS. London, Printed for Sam. Smith, and Benj. Walford, Printers to the Royal Society, at the Princes Arms in St. Paul's Church Yard, 1700.