The Cancer at first is not so big as a Pea, being a small, hard, blackish Swelling, sometimes livid, and very troublesome by reason of its Prickings; but when it is encreas'd, the Tumour appears hard, Lead-colour'd, and livid, causing in the beginning a Pain that may be pretty well endur'd, but in the increase it grows intolerable, and the Stink is extremely noisome. When it is ready to Ulcerate, the Heat is vehement, with a pricking Pulsation; and the Veins round about are turgid, being
fill'd with black Blood, and extended as it were the Feet of a Crab or Crey-Fish, till Death happen. When this Tumour is not ulcerated, it is call'd an Occult Cancer; and an Apparent one when it breaks forth into an open Ulcer.
To palliate an Occult Cancer, and prevent its Ulceration, a Cataplasm or Pultis of Hemlock very fresh may be apply'd to the Part. All the kinds of Succory, the Decoction of Solanum or Night-shade; the Juices of these Plants, as also those of Scabious, Geranium or Stork-Bill, Herniaria or Rupture-Wort, Plantain, &c. are very good in the beginning. River-Crabs pounded in a Leaden-Mortar, and their Juice beaten in a like Mortar, are an excellent Remedy; as also are Humane Excrements or Urine destill'd, and laid upon the Occult Cancer: Or else,
Take an Ounce of calcin'd Lead, two Ounces of Oil of Roses, and six Drams of Saffron; let the whole Composition be beaten in a Mortar with a Leaden Pestle, and apply'd. The Amalgama of Mercury with Saturn is likewise a very efficacious Remedy.
In the mean while the Patient may be purg'd with black Hellebore and Mercurius Dulcis, taking also inwardly from one Scruple to half a Dram of the Powder of Adders, given to drink, with half the quantity of Crab's-Eyes: But very great care must be taken to avoid the Application of Maturatives or Emollients, which wou'd certainly bring the Tumour to Ulceration.
When the Cancer is already ulcerated, the Spirit of Chimney-Soot may be us'd with good Success; and the Oil of Sea-Crabs pour'd scalding hot into the Ulcer, is an excellent Remedy. But if it be judg'd expedient entirely to extirpate the Cancer, it may be done thus:
The sick Patient being laid in Bed, the Surgeon takes the Arm on the side of the Cancer, and lifts it upward and backward, to give more room to the Tumour; then having pass'd a Needle with a very strong Thread thro' the bottom of the Breast, he cuts the Thread to take away the Needle, and passeth the Needle again into the Breast, to cause the Threads to cross one another. Afterward these four ends of the Threads are ty'd together, to make a kind of Handle to take off the Tumour, which is cut quite round to the Ribs with a very sharp Rasor. The Cutting is usually begun in the lower Part to end in the Vessels near the Arm-Pit, where a small Piece of Flesh is left, to stop the Blood with greater Facility: Then having laid a Piece of Vitriol upon the Vessels, or Bolsters soakt in styptick Water; the sides of the Breast are to be press'd with the Hand, to let out the Blood and Humours; and an Actual Cautery is to be lightly apply'd thereto.
The Dressing.
The Wound is to be dress'd with Pledgets strew'd with Astringent Powders, a Plaister, a Bolster, a Napkin round the Brest, and a Scapulary to support the whole Bandage.