Case V.—Mrs. P. A., aged 46, noticed a lump in the left breast two weeks before it was removed, in this Hospital, two years previous to her first visit to me at the medical clinic for cancer in the hospital. Three months later the right breast was also removed on account of a lump found there. All seemed to go well until about a year ago, when cutaneous nodules appeared on the chest, first around the site of the former operations; these increased till seen, when, as she now tells you, there were fully fifty of them, forming a veritable cancer en cuirasse, absolutely inoperable, of course. She was habitually constipated, depending on medicine.
Being placed on the “green card” diet and the same mixture, though with considerable cascara in it, and all the affected area painted night and morning with Thiol in olive oil, fifty per cent, she seemed to improve at once, and it was recorded that, after removing a crust which had formed with the thiol and talcum powder over it, all the nodules were less red and much less elevated. A small raw surface had formed, which was touched with thorium paste, diluted to 25 per cent. This surface was found entirely healed two weeks later, but other larger raw surfaces have formed from time to time, which, however, have all healed completely and perfectly, as you can see, with the occasional use of the diluted thorium paste.
As you see her now the entire surface over both sides of the chest is perfectly healed, and passing my hand over all the surface there is hardly a trace of the nodules which once were so abundant. All who know anything about the ravages of cancer will realize the difference between her present condition and what would have happened under ordinary circumstances. She has had no pain since soon after beginning treatment.
I could multiply these histories indefinitely, with, of course, varying degrees of benefit, but I will trouble you with only one more case, that of one of the many patients in the wards of the hospital. In this case there were at first very satisfactory results, but after a long and brave fight on the part of the patient she at length succumbed to the dire disease.
Case VI.—Miss J. M., aged 53, was admitted to the New York Skin and Cancer Hospital, July 16, 1914. One year before there was an enlargement of the right breast, with a general hardness. Later it became discolored and a blue ring appeared around the whole breast, and some purulent discharge from the nipple. Three months before entering the hospital the breast softened in one place and ruptured, discharging pus and blood. There had been some pain from the beginning, and latterly it was more constant and severe. On admission the tumor involved the whole breast, which was hard and immovable, with an ulcerating surface over almost the whole extent, with an offensive discharge, and axillary glandular enlargement. There were also small cutaneous nodules near the sternum.
She was transferred as inoperable from the surgical to my service on August 26, 1914; she weighed then 106½ pounds, and presented a great fungous mass on the right side about six inches in either diameter, with a profuse and very offensive discharge; she was very weak, with a septic temperature running up to 101 and over, and complained greatly of pain in the tumor. She had been having X-ray once a week, which was continued for a while twice a week, for twenty-four exposures, but without apparent effect. She was very constipated and passed a small amount of urine.
She was placed at once on a vegetarian diet (green card) and the same mixture as the other patients, for a while, and a little later was given dialyzed iron during the meals; the wound was dressed with a one per cent solution of permanganate of potassium, later with Russian oil, with some use of peroxid of hydrogen to check the suppuration.
For a while she seemed to do remarkably well, the color and strength improving, with less pain and very comfortable nights, without an hypnotic. In a week her weight had increased to 110¾ pounds, but then it fell off a while, but on October 28th it had risen to 111¼ pounds. As there was still a great mass of fungating tissue, helping to keep up the toxic condition, quite a portion of it was excised on September 29th, just after which the hemoglobin rose from 75 to 80 per cent, which was maintained for six weeks, the red blood corpuscles increased to 3,490,000 and the leukocytes diminished to 8,500 from 10,000 when she first came under my care.
The general condition had improved so greatly that she was out of bed all day, but the body weight dropped quite a little, to 104½ pounds, only to rise again four weeks later to 111¼ pounds. By October 10th the wound was secreting very little, she slept well with no opiate, and complained little of pain, day or night, and by October 28th it seemed as though the disease was being overcome, as there was some evidence of cicatrization in certain portions of the wound. All this continued for a month or more, when she had a number of severe hemorrhages from the wound and the hemoglobin fell to 60 per cent and the red corpuscles to 2,100,000. From this, however, she rallied under an intravenous saline injection and Murphy drip, and the hemoglobin rose to 75 per cent, and on May 21st the red corpuscles were actually 4,110,000.
I must not weary you with too many of these details, nor can I indicate to you the varied treatment which was employed from time to time. I can only add that she had her ups and downs, but finally succumbed on July 3rd, 1915, about a year after entering the hospital.