From the first her general condition improved and she began to gain weight, even several pounds a week, being weighed every week in the same hospital wrapper, by several nurses, who took great interest in the case. I could hardly believe that she weighed 128 pounds on a Monday, as reported, and on the following Wednesday I weighed her myself and found that she weighed 130, which was quite a little over that called for by her height and age, and ten pounds more than she had ever weighed before. She had been taking for some time pyrophosphate of iron, five grains after eating, in addition to the mixture mentioned, which had hardly been changed since she entered.
The blood, which was carefully studied weekly, steadily improved until, on September 18th, the hemoglobin stood 95 per cent, with 4,600,000 red blood corpuscles and 8,000 white, and on November 10th the hemoglobin reached 100, and the red corpuscles 4,700,000. The urine, which presented albumen and granular casts on admission, had lost these, and on November 10th she passed 1,000 cc., with a specific gravity of 1.025, and normal in every respect, except a faint trace of indican.
You will now, however, be specially interested when you see the change which has been wrought in her face by Dr. Semken, one of our attending surgeons, who performed a plastic operation on her, beginning Nov. 14, with the preparation of a flap on the right arm. This flap was lined with a Thiersch skin graft from the leg, so as to secure a proper mucous lining in the mouth, and left in situ until Nov. 24, when it was attached to the face, after the scar tissue had been cut away. The arm was held in place by a plaster of Paris dressing until yesterday, when the attachment to the arm was finally severed, after several partial separations. The skin graft took from the first, without any drawback, and now you see the opening entirely and perfectly covered. You will notice that the ectropion, which was so marked when you first saw her with the ulcerating surface, has about disappeared, and Dr. Semken believes that there will be still further improvement in this respect.
I must not keep you longer, though I should have liked to narrate other cases of carcinoma in other locations which are of interest. I trust, however, that you have heard and seen enough to be quite satisfied as to the correctness of the principles I have tried to lay down, and also as to the success following their proper and careful application. How far they will serve for cancer in general, as it affects various organs and parts of the body, remains to be seen, when many others have reported their results. Whether also this line of thought will apply to sarcoma in general remains to be seen, for sarcoma is really of much the same nature of malignant cell growth, only affecting the connective tissue elements instead of the epithelium.
In closing I must again remind you that it is no trifling matter to undertake the treatment of cancer by dietary and medicinal means, even though from what you have seen and heard you may think otherwise. Each case requires the utmost careful study and adaptation of remedies as may be indicated to bring the patient into a condition of perfect health. Diet alone will not accomplish this, but without the proper diet, as already indicated, all other efforts are unavailing to check the dire disease. With the proper carrying out of every detail the success is certainly much greater than with surgery, and with advancing knowledge and practise along these lines we shall undoubtedly see a satisfactory diminution in the deaths from cancer, whose death rate has so steadily risen under the measures heretofore employed.
SUMMARY
THE REAL CANCER PROBLEM[[2]]
Cancer has long been a problem over which master minds have wrestled, and to read much that is written it would seem that we were yet as far from its solution as ever. Countless able men, at the expense of millions of dollars, have labored faithfully in the laboratory, and it may safely be said that more effort and time have been expended in investigations on cancer, and more has been written concerning it, than ever in connection with any other disease affecting humanity. And yet its mortality is steadily increasing pitifully, in spite also of active, skilful, and faithful surgical treatment.
Is it not possible, therefore, that there is something wrong in our conception of cancer and its treatment? If any other disease presented such a steady and alarming increase in its death rate would we not stop and consider if our treatment were the best possible? If with the introduction of antitoxin the mortality from diphtheria had steadily risen until it was about 90 per cent of all cases, would we persist in employing it? And yet the profession and the laity go blindly on, with the idea that surgery offers the only hope of reaching cancer, when the Mortality Statistics of the United States show that under this line of treatment the death rate has risen steadily from 63 per 100,000 of the population in 1900 to 81.1 per 100,000 in 1915, or 28.7 per cent.
Surely the lesson taught by the steadily and greatly decreased death rate of tuberculosis should teach us something of the value of most careful dietary, hygienic, and medical control of other diseases. For the great white plague, which a while ago threatened even the destruction of the race, shows now a mortality which has steadily fallen 27.8 per cent since 1900, and that even with the continued presence of the tubercle bacilli. I realize that the comparison is not quite correct in all respects, for it is well established that cancer is not due to a microörganism; but it does show us that nutritive errors are at the bottom of the ravages of tuberculosis, and efficient biochemical studies in cancer have satisfied many that the same, although different in character, are true of this disease.
In other words, erroneous nutrition, which is productive of disease of the kidneys, heart, and blood vessels, with their steadily rising mortality of ten to twenty per cent since 1900, as shown on the chart before you,[[3]] is operating to steadily increase also the morbidity and mortality of cancer, in spite of active and intelligent surgical treatment. And yet the profession and laity seem to be blind to this fact.