(a) Malignant tumours.
Certainly we have no warrant for supposing that in any, except cases of the extremest rarity, the ‘undermind’ can possibly effect a cure. But in a very large number of cases which are taken sufficiently early and are otherwise favourable, extirpation by the surgeon’s knife can and does save the life of the individual and prevent recurrence of the tumour. I say again that an attitude of hesitancy on this subject by those who, like Mr. Dearmer, approach the question in a scientific spirit, and their quasi-acceptance of the alleged cures of cancer by spiritual and other healers, which hopelessly break down when anything like impartial investigation is brought to bear on them—all this is likely to be productive of infinite harm. In the case of cancer or sarcoma a day’s delay may make the whole difference between hope and despair.
(b) A class of disease of which a good example is tuberculous affections of bone.
Here we have to do with what is strictly a non-malignant condition. That is to say, there is always a fair ground for hoping that surgery may operate like auxiliary steam power in the battleships of the Crimean period. Help nature (or the ‘undermind’) enough and, other conditions being favourable, a tolerably satisfactory result may be expected. But, really, clinical experience in all civilised communities for the past fifty or sixty years must be allowed to have some value; and the value surely lies in this, that the experienced surgeon knows more or less exactly when to excise or scrape and when to refrain. That anyone should prefer to this the services of some unqualified, inexperienced ‘healer,’ who bids his patient trust in prayer, unction, or whatever his method is, telling him that if his faith is sufficient the largest sinus will be cleared up and the most distressing ankylosis broken down, simply strikes me with amazement. If the ‘healers’ really wish us to believe their claims, let them produce a properly codified list of cases which can be thoroughly investigated.
(c) Diseases in which certain drugs are empirically known to act with marked success, e.g. malaria. Here, properly graduated quantities of quinine can and do effect an absolute cure. There is no evidence whatever that suggestion in any form can do the same.
(d) What may be called progressive organic conditions, e.g. cirrhosis of the liver.
I entirely agree that, in the conditions of which this is an example, scientific medicine can only hope to ameliorate and render life more tolerable to the sufferer.
But here I come to close grips with our author, whose close and fair reasoning it is a real pleasure to follow. In a very large proportion of the diseases from which people die, the pathological condition consists in the deposition of fibrous tissue in some organ or part of the general system. The causes and clinical varieties are endless, but the result the same. To instance only a few, we have:
(a) Granular kidney, i.e. chronic Bright’s disease.
(b) Cirrhotic liver.