But the anomalies of this clinical history could not be expected to be confined to the therapeutic side. Nor were they. The Research Department of this Commission has busied itself with bio-chemical tests for cancer, and among others the Bendien flocculation test: which, whatever may be the experience of others, has proved in competent hands as valuable as Benedict for Glucose or Wassermann for Syphilis.
Accordingly, at the commencement of treatment a blood specimen was sent to a leading institution for Bendien examination, and the finding there was to the effect that evidence of malignancy was absent. This appeared to us the latest instance of the old battle of laboratory versus ward. Of the real nature of the case there could be no doubt-the evidence would be tedious to recapitulate.
Therefore a second blood sample was promptly despatched to Dr. Cronin Lowe, whose report was to the effect that the specimen was highly charged with malignant elements. As this was quite early in the course of treatment it coincided with our diagnosis. But it gave no evidence of tendency to recovery or otherwise: this was reserved for a second test several weeks later.
Still on this important point the oracle was dumb. That the patient has been loaded with a malignant growth the clinical condition and the Bendien findings were definite and emphatic. But had the malignancy become less quantitative or qualitative than before? In a word, was the patient regaining her normal health? The clinical findings were clear and consistent on this point. The patient was regaining her average health.
It is always well to have two available ports in a storm: and the alternative port in this case was another body fluid-selected by my friend Mr. Ruddle, a biological chemist of experience. This alternative body fluid was not lymph but urine. Some of the members of the Commission have deliberately chosen to experiment with this as a test fluid in cancer cases, and have found it to respond correctly and definitely in 19 cases out of 20.
Accordingly a specimen-taken under strict conditions-was twice despatched, at the interval of a month; and the finding was exactly that of Bendien. Qualitative -certainly; but quantitative-with the interference that might be drawn from a lessened output-no response.
Therefore I have asked my friend, Dr. Cronin Lowe, with the vast personal experiences of 2,000 cases, to come down and explain, as he did at Norwich, if a positive Bendien varies in intensity as the cancer toxaemia varies; or remains as a permanent blood response -as an immune body in bacteriology at least for any indefinite time.
I may say that while blood and urine tests had nothing to say on the question of recovery, the patient moved through the common round, the daily task, exactly as before. The avoirdupois continues to show a weekly increase; her powers of sleep resemble yours and mine; her cardiac cycle is still a matter of customary use and wont; and she can drive twenty miles up to my house without turning a hair.
Nor can the most careful physical examination reveal anything abnormal beyond the bare remnants of a former definite and extensive pathology. Nor does X-ray examination, that customary present help in time of trouble, vouchsafe anything beyond the verdict- “nothing abnormal”.
2. The time limit of recovery is also somewhat startling. To be dismissed from hospital while under high and distinguished professional care as an incurable malignant case with an expectation of life of at most three months; and at the end of a month to have recovered sufficiently to pursue the convalescence safely at home and at the termination of three months to have practically regained all the lost avoirdupois; for the dysuria, and blood and pus in the catheter specimen to have become things of the past; to have both P.V. and P.R. telling a tale of absorption which is almost complete – all this implies the introduction of a new factor into the daily being and doing; and that new factor I submit is that of therapeutics.
And particularly in that the therapy was not of the experimental kind, or was minus the warrant of similar issues in a number of similar cases.
Here is another case:- Two years ago I was called into the Midlands to see a lady who twelve years previously had had the operation known as subtotal hysterectomy, performed for fibroid. All went well for nine years, when the accession of haemorrhage – the continuous loss of avoirdupois up to two stone – the presence of irregular and fixed nodulation in the pelvis, told their own story. Cervicectomy was performed but to no end: the symptoms and pathology persisted. And again therapeutic was prayed in after surgery and radiology had drawn a blank.
The remedies were not those of this evenings case, but small doses of Cacodylate of Soda together with a homoeopathic preparation of cancer tissue itself in high dilution. In six weeks I chanced to see the lady again-found the erst while derelict in the drawing-room, sitting up and with a smile on her face. “I am getting well,” said she – “I am getting back my lost weight – I have lost my pain and discharge-and can I walk round the grounds on my husbands arm?”.
All this in the short term of six weeks! I saw no more of her for a year and a half, when at my request she came to town to show herself. “I am quite well,” said she-and my distinguished colleague, Dr. Granville Hey, who made an independent examination, concurred.
Such rapid progress does occur occasionally under therapeutic activation and control, though I regret that with our hitherto all too limited experience we find ourselves cribbed, cabined and confined, all too often when we wish to repeat successes. When we can add another half century to our knowledge and practice we may expect that malignant disease will be as tractable as tubercle or diphtheria.
Ladies and gentlemen, I have cited this case this evening as a recent experience and with the reasonable assumption that the mathematical law of averages will provide you and myself-if we do not miss them-with others of similar strain. In so complicated a totality as carcinoma-variable in time limit, in individual bodily resistance, in intimate organic structure, in readiness of therapeutic response, and in precancerous antecedents, items all of which go to make up a cancer case-there are always one or more points of lesser or less resistance which encourage the ardent therapeutist not to say die.
It was this inspiring spirit which encouraged Lister and Koch and Almroth Wright in the last century to never say die.
In this building, not so long ago, the then leading surgeon of the day-facile princeps in surgical art and science – was delivering himself as he came downstairs of obiter dicta on involved medical problems. “And what about cancer, my Lord,” said I. “In fifty years,” said he, suddenly pulling up,” cancer will be a curable malady.” “Yes,” said I, “magnificent; and by surgery?” “No,” said he with an ominous growl, “not by surgery- we shall have then the controls and remediation of cancer in the hollow of our hands, to manipulate as we will”.
