Miscellaneous Measures.
—A large number of suggestions concerning the treatment of cancer have emanated from various sources and from men of widely different views. Beaston, of Glasgow, being impressed by the physiological relationships and sympathies between the ovaries and the mammary glands, has suggested the benefit of the removal of the ovaries in hopeless cases of mammary cancer, holding that the nutrition of the mamma being thus influenced there would be more or less subsidence of pathological activity. He has reported instances in which, apparently, this measure had the desired effect; nevertheless it has not found general favor.
Based upon views concerning the hyperacidity of the blood and tissues in the cancerous condition, it is believed that there is a pronounced indication for the internal use of alkalies; and the hypodermic injection of 5 minims of a 1 per cent. solution of a chemically pure soap has been recommended by Webb, on the theory that it promotes the separation of cholesterin from the living cell. He would increase the dose until 60 minims are given at one time, every other day. A 20 per cent. solution of Chian turpentine, dissolved in sterile oil, has also been recommended to be used in the same way. These are recent suggestions of unknown value.
In the general management of cancer patients, two things should be kept in mind: (1) That they are entitled to relief from suffering in the least harmful way in which it may be offered, and (2) there comes a time in the history of many of these cases when all other considerations may be set aside in favor of comfort and tranquillity. Opium and other “drugs that enslave” have their disadvantages, but these cannot outweigh the benefit which they may confer in the last stages of cancer. The terminal pains of malignant disease should he assuaged at any necessary cost of other considerations.
But while all this is going on elimination must not be neglected. Opiates are peculiarly liable to diminish secretions and peristaltic activity. The skin, the kidneys, and the bowels should be kept active by measures which serve this purpose, and if it be desirable to prolong life, nutrition should be regulated and frequently administered, but it is absolutely necessary to maintain elimination.
The latest suggestion, viz., to treat cancer by injections of pancreatic ferments (trypsin and amylopsin), seems to the writer to be based upon erroneous notions concerning the nature and causation of the disease, and to hold out only specious hope of self-justification.
CHAPTER XXVII.
THE SKIN.
It is proposed here to treat only of those diseases of the skin which may complicate surgical cases or call for surgical treatment.
Dermatitis may be produced by chemicals, caustics, and various irritants; the former, for instance, by the use of strong antiseptics upon sensitive skins, and the latter as when fecal matter or urine is poured over unprotected skin or allowed to remain in contact with it. Ammoniacal urine will prove irritating, as will also that of diabetes. When carbolic acid was in general use it gave rise to great trouble upon the hands of many surgeons, while iodine, iodoform, and other such remedies, as well as the stronger mercurial preparations, will cause local symptoms similar to those produced by poison ivy.
This may be prevented, when the condition has occurred, by applying soothing lotions or mild astringents, with anodynes, in dry dusting powder or in ointment form. Cocaine in small amounts, or preferably orthoform with menthol, may be employed in either of these ways. When an acid discharge is expected the skin should be protected with an ointment or with collodion or rubber cement; the latter by drying will leave a thin film upon the surface. Thus around a fecal fistula the skin will be irritated and more or less macerated, and should always be thus protected when possible.