Dr. Ross had operated much in cancer, but, realizing the inefficiency of surgery to cure the disease, he wrote very severely in regard to cancer surgery in the opening chapter of his book. After “ten years of constant microscopic, clinical and surgical research,” he advanced the hypothesis that “cancer is due to a want of balance in particular mineral salts of the body, and that the disturbance of this balance leads to the disorderly and malignant growth of epithelial cells (epiblastic and hypoblastic) which is professionally known as Cancer or Carcinoma,” and that the main disturbance is in regard to the potash balance in the body. By very careful deductive and inductive reasoning, and by actual experimentation and practise he shows how this answers and explains more of the puzzles and intricacies of the cancer problem than any other hypothesis. In the previous chapter I referred somewhat to his interesting studies on cell polarity, the red blood cells, and the probable rôle of mononuclear leukocytes in inducing cancer-genetic changes in the tissues.
Pardon this rather long reference to Dr. Ross, who was much misunderstood by his fellow practitioners because of his blunt expressions and his presentation of a new thesis regarding cancer, which was not grasped, and, as far as I know, has been neglected by the profession; his book was published in 1912, and has only rather recently come under my notice. He died the following year, but at the end of the book, three months after it was written, he added a note stating that “all the cases described therein have continued to improve under treatment, until some of them have practically ceased to be cases of recognizable cancer.”
It is, therefore, not a little satisfactory to find from a cancer surgeon such microscopic, biochemical, and clinical explanation and support for the treatment which I have followed for thirty years and more, and which I am now presenting for your consideration. Dr. Ross makes three references which in a measure support the potassium theory of cancer.
1. “The old physiological adage ‘Potassium is the salt of the tissues, and sodium the salt of the fluids of the body’ still holds good as an absolute physiological truth.”
2. “Animal physiology teaches us that the whole range of the animal creation, from an ameba to man, follows the same law, ‘Potassium is the salt of the tissue cell.’”
3. “Examination of the botanical world brings us face to face with the same identical statement ‘Potassium is the salt of the chemical physiology of the vegetable cell.’”
The first treatment, therefore, which is given to these patients is potassium acetate, as previously mentioned, in combination with nux vomica, and some cascara, and rumex fluid extract; this latter is one of the old alternative remedies which I have used for years with most favorable results in certain skin diseases. In some of the cases related two years ago and in some of those I shall report in the next lecture, this mixture, with little variation, has been employed almost from the first to the last, with occasional alternation with other remedies. Dr. Ross has used principally the citrate of potassium and phosphate of potassium combined, which he gave in doses up to 90 grains per day, and even more. I have quite recently used the same, though in smaller doses, but it is too soon to report any results, and do not know if they will serve better than the acetate, which I have so long employed. Dr. Ross makes the interesting statement that, having used enormous quantities of potash salts in his practise for fifteen years, for various complaints, not one single case of cancer had ever to his knowledge occurred amongst the clientele of his own practise, though he had constantly been engaged in operating on cancer sent to him by other medical men. I made much the same remark in one of my former lectures (p. [152]), though I did not ascribe it wholly to the acetate of potassa which I have long used so freely, but to the additional normal salts which I got from a strictly vegetarian diet.
I would not have you to understand that this is all that is to be done medically for cancer patients; on the contrary, as the case goes on over a period of time, a thousand changes may be necessary to meet symptoms as they present themselves. And here arises the difficulty of making exactly plain wherein lies the successful internal treatment of cancer; for unless just the proper care is given at the right time all may not go well. For this reason these patients should be seen at least once a week, and for months, and the exact state of the system learned by volumetric analyses of the urine and occasional studies of the blood, in addition to the ordinary watching of the pulse, tongue, sleep, mode of life, exercise, fresh air, absence of worry and nerve strain, diet, etc.
Iron is a very important element in the treatment of these patients, though sometimes it will be found difficult to have it rightly taken and properly assimilated. I have come to use largely the pyrophosphate of iron in powder, in five grain capsules after meals, in conjunction with the mixture referred to, half an hour before meals. Sometimes dialyzed iron, half to one teaspoonful in water, taken in the middle of the meal, acts best, though I prefer the pyrophosphate, as phosphorus in some form should always be given for some time to these patients; it is to be remembered that the iron, potassium and other elements of the blood cells are united as phosphates. Occasionally I have to give the acetate of potassium with nux vomica and infusion of quassia after meals, in place of the other mixture, which after a while may be distasteful. But remember that potassium is the sheet anchor, and also that in some way the solids in the urine must be kept up to the standard of health, as I mentioned in a former lecture, which I occasionally accomplish by adding sweet spirits of nitre, etc.
I have emphasized imperfect intestinal action as a most important element in the probable causation of cancer, and the regulation of this function will often require the very greatest care, patience, and often even ingenuity on the part of the physician. The stools should really be frequently inspected. It is not enough to inquire at each visit if the “bowels are regular,” but the matter must be patiently investigated, as to the character, quantity, color, odor, hour of defecation, which should be after breakfast, etc. Nor is it enough just to order purgatives or laxatives from time to time, but such attention should be given, and such remedies and measures applied, as will secure the best possible performance of this most important function. The mixture just spoken of, altered as required in regard to its cascara content, will often suffice, but many of my patients also secure a full and free intestinal relief each week, by means of the old pills which you hear me order so often in this clinic: ℞ Massæ hydrargyri, Extr. Colocynth. Comp. āā gr. x, Pulv. Ipecac. gr. ii. M. Div. in capsules No. IV. Take 2 at bedtime and 2 the second night after. I also use greatly the excellent combination of ℞ Podophyllin, Cascarin, Aloin, āā gr. ¼, M. one or more of these at bedtime, as needed. I do not approve of mineral waters or saline laxatives in these cases, nor of mineral oil, and never employ enemata, except for emergencies.