THE POST-PROVING SPHERE OF DRUG ACTION IN RELATION TO THE THERAPEUTICS OF TUMOURS.
One very great, almost insurmountable, difficulty in the homoeo- therapeutics of tumours, lies in the inadequacy of our homoeopathic provings, which are not carried far enough to produce hypertrophy of degraded tissue, and usually not even far enough to degrade the tissue. And indeed it may be questioned whether it would be justifiable to prove remedies on ourselves sufficiency long to set up such an organic process.
But, according to the Roman proverb, we may learn of the enemy. An article in the June (88) number of the Monthly Homoeopathic Review is here trenchantly interesting, and I therefore will not withhold it:.
ARSENIC AND CANCER.
“At a meeting of the Pathological Society in December last, Dr. Jonathan Hutchinson made a communication on arsenical cancer, of which the following abstract appeared in the British Medical Journal on the ensuing Saturday:.
“Arsenic Cancer.– Mr. Jonathan Hutchinson, F. R. S., desired to make the proposition that the internal administration of Arsenic in large doses over long periods might produce a form of cancer which was of the epithelial variety, but presented certain peculiarities. He showed a drawing of the foot of a gentlemen who had taken Arsenic for psoriasis for many years; a corn on the sole of the foot ulcerated, and at first had the appearance of perforating ulcer. Perfect immobility was not followed by any improvement. The palms of the hands had also become affected, small corns developing.
The growth in the foot was excised, and the patient recovered. The patient was now under the care of Professor Chiene; the microscopical examination was inconclusive. He also showed drawings of the hands of an American physician who had taken Arsenic for long periods in considerable doses. A rough condition of the palms and soles developed though the psoriasis was cured. These early growths in these cases he observed, parenthetically, were corns, not warts, and the growths were never papillary.
This patient then got on the front of the wrist of the left hand a growth in the subcutaneous tissue, the other hand also became affected; the growths perforated the skin and fungated; they had the appearance of a syphilitic lesion, but the patient had never had that disease. The growths were scraped away and also excised; microscopical examination was again at first inconclusive, but the opinion finally leaned to the view that the disease was cancer. The patient then came to Europe, and in deference to the opinion of several surgeons, antisyphilitic remedies were fairly tried, but gave no result.
Both hands were amputated; the patient died eighteen months later. Nodules of epithelial cancer were found in the axillary glands on the left side, in both lungs, in the supra-renal capsules, in a rib, and in other parts. He also showed drawings from another case of a lesion of the palms, exactly resembling the corns seen in the other cases. This patient had a cancerous growth in his neck, and took Arsenic in large doses, for months together; the skin became muddy and thick, and patches like psoriasis developed upon the elbows and other parts, but in the palms and soles the corny masses formed, but were not followed by cancer.
About five years ago, Dr. Clifford Allbutt had given him the particulars of a case of a young lady who had taken Arsenic for pemphigus for many years with occasional intermissions. An ulcer had developed on the crest of the ilium, the glands enlarged, a tumour formed in the thigh, and the patient died at the age of 25, owing to the enlargement of these growths. Mr. Hutchinson also mentioned a case which had been under the care of Mr. Waren Tay and himself.
The patient was a clerk, aged 34, who had taken Arsenic for a long time for psoriasis. The palms of his hands and soles of his feet were speckled over with corns when he applied at the Skin Hospital; finally, epithelial cancer of the scrotum appeared, and was excised; the patient was then lost sight of. He thought the facts he had brought forward warranted him in advancing the theory that the cancer in these cases was due to Arsenic, with the hope that attention might thus be more generally directed to the point.”.
“In the discussion which followed, Dr. W. B. Hadden mentioned that he had seen several cases of erythematous eruptions in children with chorea taking Arsenic. Mr. Eve said that he believed that epithelial cancer of the palms always presented peculiar appearances, which agreed with those described by Mr. Hutchinson, and added that lympho-sarcoma of the lungs occurred with considerable frequency in workers in cobalt mines, a fact which he thought lent support to Mr. Hutchinsons theory.
The President (Sir James Paget, Bart., F. R. S.) said that he had seldom heard an argument, founded on clinical and pathological evidence, more definitely suggesting the conclusion advanced. In this connection it must be remembered that chronic psoriasis was sometimes followed by cancer. In the face of the facts advanced by Mr. Hutchinson, it could not, he felt, be doubted that Arsenic had a power, in persons predisposed to it, to determine the development of cancer. The first two cases he had seen himself, and he had been clearly of opinion that the disease was cancerous. Mr. Hutchinson, in reply, remarked that microscopical evidence in the early stages of cancer was often conflicting and misleading.
For instance, in this American case many most competent pathologists, both in England and on the Continent, had, after examining the microscopical specimens, formed the opinion that the growths were not cancerous, yet the patient undoubtedly had cancer, and had died of it. He believed that herpes zoster was certainly produced by Arsenic; Arsenic eczema had already been described. A remarkable fact about Arsenic eruptions was that they were never symmetrical.
“The only lesson that the members present, when Mr. Hutchinson made this communication, would learn from it would be that they should be more cautions in prescribing Arsenic in the future. This, indeed, is admitted by The Lancet in its ensuing number.
To those members of the profession who have learned by experience that Hahnemanns therapeutic rule — similia similibus curantur– is indeed the bridge that spans the gulf so long fixed between the pharmacologist labouring to elucidate the mysteries of the subtle actions of drugs upon the complicated and intricate human organism, and the therapeutist struggling to apply these results to the successful treatment of disease (British Medical Journal, August 9th, 1884), it has a far higher value.
Perhaps we should rather say that it would have had such a value, were it not for the fact that the study of the symptoms of chronic arsenical poisoning had long since taught us the importance of Arsenic in the treatment of cancer. Long previous to Hahnemanns time, Arsenic was an empirical remedy in cancer. But the selection of this drug by the light of the rule of similars has enabled us to differentiate those cases of cancer which are most surely benefited by it from those in which it is less efficacious. Thus, Dr. Dudgeon, in his article on Arsenic in The Hahnemann Materia Medica, part I, p. 24 (1852), writes:
It merely palliates true scirrhus and medullary tumours; it is, however, curative in chancroidal tumours, as Dr. Bennett calls them, or, according to Mr. Paget, “epithelial tumours.” So, too, Dr. Hughes says (Pharmacodynamics, p. 261, 4th ed., 1880), in epithelial cancer — as of the lip, face, and tongue– Arsenic has unquestionably proved curative, and that not seldom. Lastly, Dr. Pope, in a lecture on Arsenic (Monthly Homoeopathic Review, vol. XXX., p. 414), writes: In some cases of cancer Arsenic is, by the peculiar character of its influence on the quality of the blood, as well as by the symptoms of general constitutional adynamia it produces, and the local burning and ulceration it excites, well indicated and often useful . . . . It is in epithelioma that Arsenic can be prescribed with the greatest advantage..
“Our selection, then, of Arsenic as remedy in cancer has been mostly confined to the epithelial variety of the disease. We have in Mr. Hutchinsons contribution an illustration of its producing a condition exceedingly similar to this form of the disease — so much so, that Mr. Eve remarked that epithelial cancer of the palms always presented the peculiar appearances which agreed with those described by Mr. Hutchinson; while Sir James Paget stated that it could not be doubted that Arsenic had a power, in persons predisposed to it, to determine the development of cancer.
“Our contemporary, The New York Medical Record, in referring to Mr. Hutchinsons paper, and his belief that Arsenic may produce, or at least be an exciting cause of epithelial cancer, and after stating that Sir James Paget held the same view, adds, this will be joyful news to our homoeopathic brethren..
“We certainly are glad to find our opponents, more especially such as have in years gone by been known to us as particularly bitter opponents, confirm the truth and accuracy of our drug pathogenesis by observations of their own. Let us now suggest to them to test the value of our therapeutic application of our pathogenetic observations, by giving Arsenic as a remedy in cases of epithelial cancer”.