Cancer of the womb: its prevalence. Depressed spirits inimical to treatment. Passiveness of mind, not faith, required. Case of uterine cancer given, greatly relieved. Another case where operation had failed. Uterine tumour pressing on rectum where operation was refused, rapid improvement. Laurocerasus, remarks upon. Fibrous tumour of the womb: case given.
OF all the diseases that afflict mankind there is none the ravages of which inflict more suffering and distress than this awful present-day scourge. The Sweating Sickness of the middle ages, followed as it was by plague, small-pox and by cholera all had an immediately terrorising and paralysing effect. But it is doubtful if any one of these very fatal epidemics has in its fell swoop disseminated a tithe of the distress that uterine cancer is insidiously and progressively causing at the present time.
This, however, is not a favourable opportunity for pausing to contemplate the magnitude of this terrible scourge. But it is a very desirable occasion for impressing upon woman-kind the necessity for struggling in every way against indulgence, for it is often nothing but an indulgence, in depression of spirits. We are all products of our Mother Earth, and where, may I ask, on the surface of the globe do we find any living thing animal or vegetable when placed in a position suitable to its requirements, living in a way that does not betoken a happy joyousness? The little flower that lifts its face to heaven, no less than the fierce tigress with its cubs, returns thanks to its Creator in manifestation of an innocent contentment.
Should like enjoyment not be forthcoming amongst human beings, it behoves them to carefully study and endeavour to correct an environment that must be inimical to their best interests. The man or woman who succeeds in doing this must necessarily be happy.
The effect of mental depression is more noticeable in the cancers of the womb than in any other form of this shocking scourge. Naturally, too, the action of remedies upon the disease is much more unsatisfactory when sorrow lurks within, and clogs, as it assuredly will, the channels for nutritive material throughout the system. Let it therefore be understood, if I express a favourable opinion upon the power of remedies upon these diseases, that I am free to confess that the greatest successes are gained where the sufferers struggles successfully against mental depression caused by domestic and other worries. The proverbial idea is that a patient must have faith: in a sense it is quite true, but equally certain is it that the physician ought to prescribe a remedy such as will give this desirable faith to the patient. For in Medicine seen and felt; and it behoves the prescriber to regulate his prescriptions so that as possible of this kind of faith may be secured.
The physician who requires his patients to have faith in him before he furnishes them with evidence upon which to found their faith is, to put it mildly, unreasonable. For myself, I admit readily that I seek to cultivate faith in my patients, and the instrument, and the only instrument I employ, is what appeals rationally and soberly to their senses a vital force working upon a vital force. My reason for introducing these consideration at the present juncture is to give me the opportunity of frankly acknowledging that my advice to all patients suffering from chronic disease is to remain perfectly passive in mind when first coming under treatment.
A treatment that begins by endeavouring to secure a patient’s confidence is a humbugging affair; but a treatment that ends by the establishment of a patient’s faith by relief of his sufferings is one that aims at a natural sequence of events. The best thing a doctor can do to a patient who enters his study in a querulous and suspecting frame of mind, both for his own and his patient’s benefit, is to show them the hall-door, or, as the French would say, donner la clef des champs. A seriousness and determination to get cured is almost is necessary as an equally serious determination on the doctor’s part to effect a cure.
In the complaints of women, but particularly in uterine cancers, the need for complete passiveness of mind in the commencement of treatment must be insisted upon.
Cancer complaints of all varieties and in every situation seem to feed upon depressing emotions. Equally true is it that half our sorrows are self-inflicted, and therefore ought to be carefully guarded against.
In the first edition of this work I brought forward a case of undoubted cancer of the womb; it was one in which the husband introduced the case to me in this letter: 24-2-99.
“DEAR SIR, Having heard through Mr. M. of your treatment of his disease, I venture to write concerning my wife, who is suffering from cancer of the womb. Three years ago we thought she was suffering from change of life. She was examined by Dr. B. of this town, and he told her there was nothing the matter, only change of life, but that the left lip of the womb was swollen. It has been going on like this ever since until last november, when she was examined by Dr. J. and Dr. T., and they both pronounced it cancer. They advised her to go to Brompton Road Hospital. She was there fourteen days, and was examined by Dr. B.J. under ether; he told her he could do nothing and sent her home, and told her to liver as quietly as possible….
” I was overjoyed when I heard from Mr. M. about you; I thought there was one more chance for my poor dear wife. I must tell you her appetite is fairly good. Her spirits were always good, but lately she gets very low, and I often come home from work and find that she has been or is crying…..”
And in a postscript to his letter he writes: Dr. J. said he could not operate because the cancer had attached itself to the bladder, and to cut it away would be almost certain death.”
On February 27, 1899, I sent Helleb. Vir. O A, with a request for monthly reports. On March 23 came a report that “the ninth day after the dose, a bright red discharge set in, mixed with very dark, stingy, clotted blood; at the same time I (the patient) had severe pains in my hips and back, and a sort of bearing down; could not stand or walk and was obliged to go to bed; it lasted for a few day, and I was then able to come down again. And so it has worked at five different times during the month, and between each interval I felt a little within myself. But I still at times feel a kind of stinging, but not nearly so sharp as it was before taking the powder; the stinging seems to work more towards my back passage; yesterday I felt a slight pain going towards my left breast. So, sir, (she goes on) you see I have improved; now, do you think you would like to see me?”
On April 10 the patient came up to see me, and expressed herself in the most joyful terms owing to her greatly improved feelings. A good deal of bloody and white discharge had come on during the previous week, and a feeling as if something were working about in the rectum and bowels; “is still restless at night, but the pains are less severe.”
Local examination was certainly not so assuring as the patient’s testimony; the parts were bathed in blood, which seemed to come principally from two granular masses that hung down on either side of the os uteri from a hard and fixed fundus. Further examination than this was undesirable, owing to the free haemorrhage. Three days after seeing her I sent Caltha palustris O A, and since then have had most favourable reports; in that of April 30 the patient writes: ” On fourth day after the powder, pains set in in my hips, especially the left hip; and on fifth day red but not bright red discharge as before, a yellow- red discharge, and not smooth and stringy but gritty, no clots, and it lasted only one day.
” The white discharge continues; I think the bladder has slightly improved, the probing, shooting pain is less; have felt some of it in left breast this last two weeks, very little of its towards rectum.”
The breaking-down remedy in this instance was undoubtedly the Green Hellebore. Helleborus Niger Foetidus, and Viridis, are remarkable for the production of an overpowering depression, accompanied by the fearful sense of sinking at the pit of the chest and all over the body, with laxity and enfeeblement of the muscular system and a sense of bland despair such as we meet with in the cancers, especially in scirrhous cancers. The Helleb. Viridis I find to be more pronounced in its effects on internal cancers than the Helleb. Nig., and both are certainly very often called for in cancer cases.
The Helleb. Nig. shows its full power in certain forms of facial lupus, and in old and obstinate ulcerations of the legs.
This patient has, I am given to understand, undergone a great deal of distress and serious domestic worry since this report was written, but she still, up to the time of writing, is able to keep about, and enjoy a great measure of activity. Treating a case like this at a distance, and under the most unfavourable circumstances possible, is not conductive to recovery. This patient cannot in all probability get well, poor thing, but most certainly her life has been prolonged by treatment, and with few exceptions, she has been able to do without morphia.
While I write (May, 1900), there comes to hand a most unexpectedly gratifying account, to the effect that on the thirteenth day after the last powder (Helleb. faet) a clot, of which an admirable drawing was sent, and which represented the moulding of the cavity of the womb, came away, the patient describing it as “a most curious clot; it was in some parts over an inch thick, and it was lined with white veins, and measured about six inches.”
Evidently great relief has followed, as she writes only of slight pricking and shooting. This certainly is satisfactory.
The relief given to this patient was so great that a lady aged 62, living close at hand, and who suffered from a similar malady, came up to consult me. Briefly her case ran; Six years ago had a complication of ailments, diarrhoea, asthma, &c., and had to lie up five or six months. Then a fibroid tumour of the womb was diagnosed, but year after, though suffering from haemorrhage, the tumour could not be felt. A year ago she passed long fungoid- looking masses and clots of blood, a nd was declared to have cancer of the womb, and to be incurable. Operation was tried by one of the first operators in London, and proved unsuccessful, and it was found impossible to remove all the growth. At the time of consulting me on May 6, 1899, she was having antikamnia tablets, as the injections of morphia had disagreed so frightfully with her. Her symptoms were great back-ache, and bearing down from a feeling of weight, chiefly on the right side, and much pain round the navel, with sinking in the pit of the chest, slight constipation, but no dysuria.
This patient has, of course, required a good deal of treatment; this has not been essentially different from that adopted in other cases, Crocus Sativus and Vernalis, Helleborus Niger, Laurocerasus, and other remedies have been given as the symptoms indicated, and now I am pleased to say the lady is in the enjoyment of really good health; digestion and strength are good, and there has been no loss of flesh. With one exception, last September, when she had a good deal of suffering for a week; she has been almost free from pain. Surely a treatment like this is better than operation or morphia drugging. It is not to be supposed that cases which have gone so far as this had can be cured.
If, in the last case, there is little to be learned, in the next there is, on the contrary, a very great deal of valuable instruction.
A. C., aged 54, married 30 years, nullipara, miscarriage two years after marriage, subject up to two years ago to bilious attacks from the age of 17, has been under treatment for four years for uterine haemorrhage, but nor till two years ago was a growth from the wall of the uterus detected. Operation was discountenanced, the tumour being evidently thought malignant, and this by a foremost consultant in women’s diseases. The consulting surgeon, of, I believe, the Samaritan Hospital, was then consulted, but declined operation on consultation with others. The symptoms are simply haemorrhage, going on every day, generally bright in colour, has only a few hours’ interval in the twenty-four, and last week was practically excessive. Much back- ache, and pain with the clots, and feels the tumour pressing upon the bowel. Much constipation, for which she has to take medicine, and restless sleep from the back-ache. Lately pain in left shoulder and behind left breast. On local examination a very weighty mass was found pressing down into the passage. That the case was considered one of great urgency is evident from the fact that her medical attendant declared that colotomy would soon have to be performed.
On January 5, 1900, I prescribed Laurocerasus O A, and a pill every night of 3 grs. of simple ox gall.
On January 19, came the very cheery intelligence that though she had had much pain night and day for the first week, for the second had less pain then for two years; and that, whereas formerly she felt ill and uncomfortable when the pain lessened, this was not now at all the case. Still has back-ache, but pains in the left shoulder and breast are gone Nil.
On February 2, reports: From January 22 to 26 had much pain, and on the night of 23rd much acid vomit came up, with fainting feeling across abdomen and left side up to the head; haemorrhages for two three days, but no clots as she used to have in quantities. Is much stronger, though bowels are more confined. The dose of January 5 again.
February 16. Has been much better up to 13th, and then passed clots, but much less than before treatment; these are sometimes dark, but sometimes bright, and are accompanied by back-ache; the act of walking causes pain over left thigh and groin, but still can walk much better, and it does not bring on haemorrhage. Crocus Sativ. O A was then given, and her report there upon is very significant. On the same evening had a great deal of pain across the lower back, and slept but little that night and the next, and on third night had cramp in the stomach as well as back-ache and diarrhoea, and since this has been much better. No medicine was given on this occasion, and when seen a month afterwards she declared herself better than she had been for four years. It is unnecessary to follow the treatment further. When seen on May 4 she was feeling in every way improved, was walking about in perfect comfort, and except that she still felt weak with dyspnoea on going up heights, and that there was still some oozing discharge, she was without the slightest suffering.
I have stated that this case was instructive; it is a very good example of how easy it is to discard the truly curative remedy. Instead of relieving the pain, the Laurocerasus caused her to have much more suffering for the first week, and had I proposed to see her in three or four days instead of in a fortnight, the changes are the right remedy would probably have been discontinued and another selected in its stead. This is why one practitioner gets good results where another, more anxious and more apprehensive, fails, even though he may use the same remedy.
This is a favourable opportunity for giving the leading indications for Laurocerasus. A sense of fatigue pervades the whole system, with a very painful condition of the hard and indurated tissue of the parts affected, this pain being in general much ameliorated by sleep; there is a tendency to an oozing of blood that is most generally bright and mixed with gelatinous clots. This applied to chest as well as to uterine and rectal symptoms, only that the blood comes painlessly into the mouth but with great pain per vaginum.
In most cases it will be found that the pains it relieves are ones that start from the lower part of the spine and extend either round the pelvis or up to the head, and are accompanied by a sense of suffocation, and a sick feeling, with drowsiness, and a great desire for sleep that generally brings relief; in cases that are sleepless the desire for sleep is very great. The digestion is weak, the bowels are confined, the patient is low- spirited, with flatulence and burning in the chest after food, and a constant tired, sick feeling, the entire frame being enfeebled, and inclined to loss of flesh and haemorrhages that are small in quantity and bright in colour. Its flatus is audible and gurgling, and rolls about the upper abdomen.
These instances of benefit from treatment are quite sufficient to establish a claim for arborivital remedies, when prescribed according to the symptoms, as being remedial in the severest possible cases, even in the most painful cancers.
That the fibrous tumours of the womb should also fall under their sway is natural to except. These tumours are less malignant in their tendency than the true cancers. As old age advances, they often develop malignant characters, according to Dr. Herbert Snow, ” Cancerous and other Tumours,” p. 25. London: Bailliere, 1898. who thus writes: ” The same holds good (i.e., tendency to malignancy) to a more limited extent with uterine myomata, the familiar fibroids. Some eventually pass into sarcomata. And though many assuredly do not, even in extreme old age, it is yet likely that with more careful observation at women’s hospitals (where pathology as a rule is not a strong point), the sequence will prove far less rare than is now held.”