SURGERY is generally Medicine at fault; Medicine caught in a blind alley! Surgery calls for a physicians knowledge and acumen; mastery of a complex, glittering technique; a proud handicraftmanship in which delicacy, dexterity, and nice accuracy of touch and movement are co-ordinated with skill and artistry.
But all the same it is the physicians confession of failure, from the first doubts and hesitancies of Hippocrates and Galen down the centuries to Ambroise Pare, Perceval Pott, Liston, Lister; right down to the white smocked, masked, deft handed surgeons of to-day.
Thoughts like these always assail the physician when he is forced to seek the aid of a surgical colleague. He may wrap up his failure in sonorous terms; mechanical obstruction; structural or organic stenosis; molecular cohesion: but he cannot sidestep the impact of logic; he cannot escape the inexorable synthesis of theory and praxis.
Just such a feeling of defeat assailed me when I was forced to diagnose cancer of the colon in A.B., aged 70, a man of sweet disposition and high courage. A year before he had suffered from haemorrhage from the rectum, losing a good deal of blood. He had been examined by a skillful and conscientious colleague, with all the resources of modern diagnosis, including sigmoidoscopy and radiography, but no irregularity was found; no tumour, ulcer, or any abnormality.
He complained to me of discomfort in the left lower quadrant of the abdomen; discomfort that frequently became rhythmical pain, travelling downwards and ending in a thin stream of haemorrhage or an exquisitely painful watery diarrhoea. He had been losing flesh and strength. The eyes were a little sunken; a little dull; a little anxious. Joy was oozing out of life; food had lost its savour; air and water their freshness; and resting was better than activity.
All this sounded very ominous from a man not yet 70; a man who belonged to open fields and the great shires of the sky; a lover of animals; plain brother of the hills, hedgerows, and the birds. More ominous still was the report that tobacco had lost its taste; that his pipe remained unfilled when he sat over his evening beer.
I was not surprised to find a mass in the left pelvic region; a mass that was stone-hard, fixed, and irregular of surface. And enlargement of liver dullness and great tenderness over one of the dorsal vertebrae told me that already cancer cells were speeding along the arterial stream, seeking new sites and fresh breeding grounds.
There was little need for X-ray diagnosis. But a barium meal and a barium enema were given; only a tiny trickle of the barium escaped through the tumour region; a trickle like a thin, twisted wire, an escape that was made with great discomfort, difficulty, and, at last, agonizing pain.
Here was evidence, if evidence were wanting, that the lumen of the bowel was compressed by an iron- like band of tumour cells. The mass was beyond the reach, though not far beyond it, of a finger passed into the rectum; widening or ballooning of the rectum was noted; and at times the examining finger was stained with blood.
For a time I looked at the elderly man from the view-point of an allopath, forgetting that I was something more! So hard does training, conditioning die! What could I do for him? Colotomy? In a day or two obstruction would be complete! Then vomiting, reversed peristalsis, distension, faecal vomiting, agonizing pain. But he was already weakening. Hollow eye, quickening pulse, deepening anxiety, all spoke of the reversal of lifes current.
Further, colotomy meant surgical nursing, dressings, frequent changes of bed linen. And there was no hot water on tap; no cold water, even, laid on. True, his wife was there; slight, not physically strong, but a tower of moral strength. I knew she was tireless, efficient, capable of any sacrifice. But she dreaded surgical interference; prayed that it could be avoided.
Without pity no man can be a doctor. The kind of pity Wilfred Owen had in mind when he wrote in the preface to his great war poems: “The poetry is in the pity.” But a doctor needs more than pity; more than healing touch; he must know how men live and get their living. And he must modify his methods of treatment accordingly.
I was not bold enough to think that I could bring health back to Mr. B. I saw no way of reversing the rapid cell-division that was building up tumour and forming metastases. I saw no prospect of quelling the rebellion that was flaring up in the dark among glandular elements which had hitherto obeyed the law and order that was life. Why were those cells seeking more abundant life along the via dolorosa that was death; defying discipline, order, sanity, health? Was it to escape the death that comes to all; to lowly cell, to peerless Helen, to all-conquering Alexander?
Some day that modest genius, Dr. E.L. Compston, [Dr. E. L. Compston, Crawshawbooth, Lancs., is a general practitioner whose leisure is successfully devoted to research work in cancer. He has achieved many good results, and has read papers to the British Homoeopathic Society. He hopes soon to be able to devote all his time to the work.] will return the answer, and outlaw cells will be brought once more within the discipline of law and life.
But the pioneer who goes out single-handed to fight the battles of humanity joins a heart-breaking service; not for him the great, shining laboratories with their acolytes, phalanx upon phalanx; not for him the broadcast and the front page service. Like Pasteur, Lister, Mackenzie, and Ronald Ross with cracked microscopic and old shed for laboratory, he must struggle alone in the dark. He must stick to his researches through the overwhelming calls and trials of private practice; jubilant if some obscure publication finds a corner for a hurried draft of his findings.
Fortunately for A.B. I had the resources of Homoeopathy to draw upon. That magnificent Materia Medica built up by the patient experimental genius of Hahnemann and his followers; men, as the magnanimous Osler wrote, stupidly, wilfully, insanely isolated from the patient body of Medicine. And all because the inertia of the orthodox doctor prevents him from exerting the intellectual energy necessary to acquire the new knowledge. For Homoeopathy is not an easy acquisition.
I decided to give A.B. Hydrastis canadensis, using the 12th, 30th and 200th potencies. I started with the lowest potency, raising the potency each day till the 200th was given on the third day. There was an almost immediate response. He became quiet, peaceful, contented. Pain gradually died away, and the face lost its anxious look. And through the tumour increased almost daily in size, fixity, and, if possible, stony hardness, there was an almost daily movement of the bowels; movement without pain, straining, and with very little haemorrhage.
About three weeks before death the abdomen became suddenly distended. Peristaltic movements were grossly visible. Pain returned; the old rhythmic pain tending downwards from the tumour. Cancerous cachexia was plain. The old haunted, driven look appeared in the eyes. And nothing came from the bowels; not even a little flatus. Again I feared mechanical obstruction demanding colotomy. But I had supreme faith in my drug. Once more I gave him a 200th and then ordered drug. Once more I gave him a 200th and then ordered an enema. The result was a large motion.
After that he declined slowly and smoothly to death; without pain, without distress; passing quietly away in his sleep.
On page 420, Vol. 2, of Transactions of Ninth Quinquennial International Homoeopathic Congress, 1927, the late Dr. Clarke describes a case like that of mine above, in which a similar result was achieved with the use of a different drug.