Actually then, the great directing idea of the officials is that cancer is a disease, firstly local, which then generalize itself, which is only grave because of this generalization and invasion of the body. That which is called the precancerous state exists only in so much local irritation, or the isolated organic inflammation can be the cause for cancer (for example, a proctitis determining a favorable state for the birth of a rectal cancer, a uterine polyp degenerating into a uterine epithelioma, etc.). Consequence: it is essential to fight these local inflammations, and act aggressively on the tumoral element in order to destroy it (be it by radiation or surgical intervention). The main argument which appears to favor this belief is the relative rarity of relapses of cancers in aggressively treated cases and the exception of cases of primitive tumors appearing successively in different organs in the same patient.
On the contrary, homoeopaths believe, in general, and other colleagues hold equally to this idea, that there not only exists at the same time but especially for some time before the appearance of a tumor, a general constitutional state or generator of cancer.
The local irritations acts only as a focus of localization; it is a thorn due to disturbances or regional tropism (tissue or organ). Consequence: Know the signs of the precancerous state in order to treat the body before the appearance of the tumor and treat the general state as well as the cancer during or after the latter. The valuable argument in favor of this idea is the possibility of obtaining occasionally a remission or an amelioration, which is only temporary, by acting on the general state and via internal channels.
In reality, if certain officials are strangely blind when they refuse to admit the existence of an already deficient general state in a clinically pretumoral phase, certain traditional homoeopaths, especially foreigners, are mistaken, in our opinion, when they neglect the extreme importance of the local factor in cancer as in other affections.
To clarify our demonstration let us take another example: an abscess or phlegmon. Before the appearance of the suppuration one can prove that there exists in the general state of the subject warning disturbances: suppurative tendency; the smallest wound is infected very easily, the patient is fatigued, there often exists cytological transformations, etc. Then the abscess forms. At this moment local signs appear and assume more and more the first position over the signs of general disturbance unless the abscess is opened and the pus exteriorized. In this case, general treatment is useful before and after; the abscess ought to be associated with local measures in the suppurative phase.
There is likewise in cancer a rational local treatment whose object is the tumoral destruction, be it by irradiation or better still by operative oblation, be it by local application of homoeopathic remedies, it should be practiced each time this is possible, for without that the treatment of general detoxication is shown to be insufficient in the greater part of the cases.
It is then to envisage homoeopathic treatment from two aspects:
Generals (remedies to be prescribed in the precancerous state as well as during the tumoral phase or after it).
Local (treatment only possible in the actual cancer period).
A. General Treatment
This is composed of:
1. Constitutional remedies
2. Cancer remedies
3. Drainage and canalization remedies.
I. CONSTITUTIONAL REMEDIES.
Numerous polychrests, habitually employed as remedies of morbid constitutions, called “basic remedies” or improperly “constitutional remedies” are quite often indicated in cancerous and precancerous patients. As elsewhere, they can also be prescribed in the greater part of the chronic disease, as Hahnemann described them. That it may be a question of psora, that state so difficult to define yet so easily recognized; that it may be a question of sycosis in other cases; that psora is identifiable, according to Nebel, with hereditary tuberculosis (with infections of intestinal origin for other authors); that it determines in the subject a state called tuberculinique or pretuberculous in others, or a precancerous diathesis in others, we should only note that, habitually, it is the same great basic needs remedies which should be prescribed in the first place. Our object here is only a practical one, namely, to present a general view of the treatment of cancer, and it is not an etiologic or pathogenic investigation.
Thus we find that depending on age sex, race, soil, climate, habits of life, alimentation, morphology, there are a thousand shades which lend these remedies an extraordinary polymorphism. It is also true that Thuja, Lachesis, Iodium, Silicea, Lycopodium, Sulphur, Sepia, Petroleum, the Calcareas, the Kalis, the Natrums, Carbo vegetabilis and animalis, Graphites, Causticum, Arsenicum album, Phosphorus, Mercurius, Nitric acid, Nux vomica, Ignatia, shall present themselves judiciously to our minds as most often characterizing the morbid state of our patients. They are for us protean remedies, for precise personalities, which are multiple, faceted, variable. They can be described in a different in a different fashion, but as true as any other, as characterizing certain hereditary psoric states in the child, tuberculinique in every age but especially in the young subject (child, adolescent, young adult): or precancerous psoric or precancerous sycotic states in adults and mature people or in the aged who frequently present associations of sycosis and psora.
We lack the space required to describe in a detailed manner the precancerous state as it is manifested in Thuja, Lachesis, Sulphur, etc., as we have previously done for the tuberculinique or tuberculous state (General View of the Present Homoeopathic Treatment of Pulmonary Tuberculosis, L’Homoeopathie Moderne, Nov. 15, 1932). The reader should refer to the materia medica, which is the premier source of all homoeopathic knowledge. Let us limit ourselves by giving only several practical indications of the value of these remedies which are habitually employed in high potency in the precancerous or even cancerous state.
THUJA: This is the king of Hahnemann’s sycosis, the diathesis which is productive of neoplasms, that are, most often, benign. These are warts, condylomata, vegetations, naevi, etc. Sycosis supervenes upon a genital infection, especially gonorrhoea, or after repeated vaccinations which are toxic to the body, especially Jennerian antivariolar vaccination.
Thuja is in the first rank of remedies for the precancerous state. In high potencies it is wise to repeat it rarely, since it can be dangerous and occasionally even precipitate a subject toward a cancerous localization.
In reality, Thuja can also act with success in the confirmed cancer if the latter isn’t too intensely malignant, and if the tumor is still localized. In such cases it can be used for cancer of the breast (degenerated adenoma) and for the cutaneous epitheliomata. In such cases one may be mistaken, perhaps, in prescribing it in too high potencies. Thuja 6 repeated often would appear to act more favorably in certain cutaneous cancers, especially in the cancroids.
LACHESIS: This is also a constitutional remedy of the first order for the precancerous and starting cancer cases. This is especially so in females approaching the fifth decade, following a period of glandular and circulatory disturbances affecting the thyroid, ovaries and liver. These disturbances are often accompanied by vertigo, flashes of heat, palpitations, general hyperaesthesia (cannot tolerate anything tied about the neck, chest or waist) and often, arterial hypertension. If there exists a bloody discharge the latter ameliorates the patient (especially the periods). If, on the other hand, there is a cessation of the discharge the condition is aggravated (menopause).
In other cases and regardless of sex, the precancerous Lachesis case is intoxicated (alcohol) or jaded. The latter’s intensive creative efforts or inventive researches have profoundly disturbed the humors and destroyed the reserves of nervous energy.
Lachesis even acts well in certain cancers, in high potencies, and without appearing dangerous as Thuja is even if its is repeated often. Its action is more general on the intoxication of cancerous origin. Thuja has a more localizing action. IODIUM: This is complementary to Thuja which is also its antidote. Patient is debilitated, weak, and wastes very rapidly in spite of his good appetite. He has the tendency to produce new connective tissues and hard glandular growths (breasts, uterus, lymphatic glands, thyroid, etc.). One must not neglect to prescribe it for it often has a favorable action on the weight and even on the tumoral element which it can cause to regress or whose induration and invasive tendency it will diminish.
SILICEA: This remedy is also related to Thuja and Iodium. It acts especially on the connective tissues in which, according to Ribbert, modifications often occur before epithelial neoformation. Lauded by Zeller, Fargas and other authors, it is suitable for the precancerous or cancerous diathesis. It can be prescribed in cicatricial degenerations (cheloids, analogous action to Fluoric acid) and especially in sclerosing tendencies with the production of new fibrous tissues. If Thuja is mentally obsessed, Iodium a depressed melancholic and anxious type, Silicea is a hypersensitive anxious type who is also capable of possessing fixed ideas.
It is essential often to employ it in middle potencies in tumors and high potencies in the pretumoral phase. Fargas also used Silicic acid in hypodermic injections, he claims with success, in several cases of cancer. Like Iodium, Silicea is demineralized and wastes very rapidly.
LYCOPODIUM: Antipsoric like Calcarea carbonica and Sulphur, Lycopodium evolutes toward cancer through its hepatic insufficiency. Its action fortifies against the precancerous state. In confirmed cancer it barely has any value since it has no power over the tumoral element as have Thuja, Iodium of Silicea.
If the hepatic insufficiency is great is should be cautiously employed in low potencies for even the 30th has often shown itself to be dangerous, in cases of hepatic blockage. It is here that the necessity for a good preliminary general drainage makes itself felt.
The Lycopodium subject who becomes cancerous will localize his tumor preferentially on the liver, stomach or intestine.
SULPHUR: King of Hahnemann’s antipsorics, Sulphur ought to be reserved for the pretumoral state. It has no favorable action in a confirmed cancer, even at the start, and can even be dangerous in this case by favoring the propagation of neoplastic cells and the wasting. On the contrary, it is essential to know that it is to be prescribed at times among these patients, generally hypertensives, whose general arterial hypertension is accompanied by an intense portal congestion which is both arterial and venous. This relieves bleeding haemorrhoids. This abdominal arteriovenous hypertension is the prelude of a cancer which will preferably localize it-self in the digestive tract or in an abdominal viseus.
In these cases an untimely local treatment, as in stopping bleeding haemorrhoids, can be very dangerous.
SEPIA: The morbid personality of Sepia is often noted in subjects in whom cancer is imminent. This remedy, like Sulphur and Lycopodium, acts favorably on a disturbed general state, but not on a tumoral element. It is characterized by a venous portal hypertension, the abdominal congestion predominating especially in the pelvis, and is not accompanied, as in Sulphur, by an arterial participation. The atony determines ptoses and the “bearing down” sensations. The endocrinal disturbances (liver, adrenals genitalia) cause the characteristic facies and the cutaneous pigmentary modifications.
Untreated, Sepia will develop rather toward a cancer of the pelvis-uterus, rectum, sigmoid colon, prostate.
PETROLEUM: This remedy is allied to Sulphur. It is curious to observe the cancerous tendency of Petroleum or of benzol and the derivatives of the oil (Pixliquida and the aniline compounds as I have already recorded). All these products act rather on the neoplastic tendency of the skin. Petroleum has cracks (<) in winter, by cold. Its intolerance for cabbages is accompanied by digestive disturbances and errors of treatment. It can also develop toward a neoplasm of the digestive mucosa as well as toward cutaneous cancer. Petroleum directs itself toward surface cancers (skin, mucosa) and not toward bulky cancers (glands).
THE CALCAREAS: Of the three great calcium salts, Calcarea fluorica is the only one which exhibits a neoplastic element. It confers on glands or connective tissue a stony induration. It is related to Silicea. It acts as well in breast and uterine cancers as in those in other organs. Calcarea phosphorica has hardly any action either in cancer or in the precancerous state. Calcarea carbonica-Hahnemann’s great antipsoric-is rather indicated among the precancerous hypothyroids, hypersensitive to cold and chilly, with flaccid muscles and integument, malnourished, invaded by adipose tissue. Blood clotting times is increased. (Joseph Roy in his blood examinations has demonstrated the frequency of too rapid clotting in cancer and precancerous cases). The subject wastes rapidly after an initial phase of false plethora and fatty invasion. Calcarea carbonica can materialize, therapeutically, the demineralizing factor in cancer. It can act selectively on the glandular hypertrophy. In suspicious and indolent ulcerations, in engorgement of lymph glands, Calcarea iodata will be indicated. Calcarea oxalica should act on the pains in ulcerating cancers.
THE KALIS: It is known that there exists in cancer disturbances of potassium metabolism as well as those of calcium, sodium and magnesium. To tell the truth, the Kalis are remedies of secondary importance in confirmed cancer. However, the precancerous cases often require Kali carbonicum (weakness, chills, lumbar pains, sweats, wasting) or of Kali bichromicum (gastric or pyloric ulcer which can develop into malignant degeneration; sluggish ulcerations, indolent, with perpendicular borders, thick discharges, viscous and flowing gently). But we shall think especially of Kali iodatum because of its selective action on the infiltrated connective tissue and on the hypertrophied glands especially after syphilis. Kali arsenicum in inveterate skin disease with fissures and malignant tendency. Kali cyanatum in lingual cancer.
THE NATRUMS: Natrum muriaticum corresponds much more to the tuberculinique state than to the precancerous state. However, among decalcified subjects it is occasionally indicated. Natrum sulphuricum is suitable to the sycotic and hydrogenoid states, sensitive to damp cold, in which the association of sycosis and psora can prepare the birth of a malignant tumor.
THE CARBOS: Carbo vegetabilis, for deficient vitality, for deficient oxygenation and nutrition, presenting a gastrointestinal atony already old and stubborn, may be indicated in cancer (especially digestive) or the precancerous state. But Carbo animalis is one of the best remedies for the established tumor; hard tumor, indurated and swollen lymphatic glands, subcutaneous venous distention, bluish discoloration of infiltrated tissues, burning pains, gastric flatulence. It has an especial selective action on the breast or stomach cancer and merits special mention not only for its beneficial effects on the general state (gain of weight or temporary arrest of wasting) but also for its action on the tumor itself which regresses, becomes less hard with amelioration of pains.
GRAPHITES: Subject is extremely psoric very chilly, oozing eruptions, obstinate constipation. Graphites can characterize, in certain cases, the precancerous state with tendency to induration of tissues and degeneration of cicatrices.
CAUSTICUM: Very clearly this antipsoric, at the same time sycotic, often veers toward cancer: emaciation, dirty yellow color, terrified aspect, tendency to facial warts, etc. In Causticum, as in other remedies.
The mental signs often are of great importance in order to characterize and individualize the patient; the precancerous subject frequently presents a weakened morale, sadness, obsessions, fear of the future, anguish, exaggeration of the sensitivity; likewise, the mental type of Causticum (hypersensitive, altruistic, sadness) or of Thuja (fixed ideas) or of Iodium (anxiety) and other remedies shall have to be considered in the choice of the basic remedy.
ARSENICUM ALBUM: Very important and often indicated, Arsenicum, by its prostration, alternating or coexisting with a certain agitation, by its burning pains, (>) by heat, its characteristic horary, clearly individualizes many confirmed cancer cases to whom it will often bring a temporary amelioration, transitory or slightly prolonged, as in very weak precancerous subjects. Selective action on the cancroids (with Thuja and Cinnabaris).
PHOSPHORUS: Poorly known, this remedy can clearly act with success before the tumoral phase when the degeneration of a gland and its nuclei is yet hardly delineated. Phosphorus has first a selective action on the higher tissues in contrast to Silicea, its complementary, which presents an efficacity for interstitial tissues. It is especially in hepatic and pancreatic cancer that Phosphorus appears. Although of secondary importance, it is worthy of attention.
MERCURIUS: By its nocturnal aggravation, its engorgement of lymphatic glands, its bleeding ulcerations, its prostration, its sweats its oral fetor, Mercurius and its salts can be retained in cancer which is localized on a part of the digestive tract, especially if it follows a former syphilis. The most interesting of the mercury salts is Cinnabaris (or Mercurius sulphuratus ruber) in condylomata which may or may not be degenerated.
NITRIC ACID: Let us remember of this remedy, complementary to Mercurius and Calcarea carbonica, its tendency to fissures and painful ulcerations (sensation of fine needles), the debility, the demineralization, the progressive wasting and thinning. It is to be thought of, then, in confirmed cancer in which it can act, if not on the general state, at least on the painful element.
NUX VOMICA and IGNATIA: Finally, these two strychnias which are not, properly speaking, remedies for the precancerous state. They merit mention, however, because of the frequency and importance of their mental signs and the beneficial action they are capable of establishing in the neuro-vegetative system and morale of our patients who are cancerous or have a cancerous tendency.
Such are the principal constitutional remedies we ought to review. The dilutions in which they ought to be employed are variable enough. In a general way, the high potencies will be reserved for the precancerous state; the low and middle potencies for the confirmed cancers.
Let us hasten to add that the results obtained with these remedies alone are very uncertain, the cases of real cure very rare, simple amelioration very variable in confirmed neoplasms. On the other hand, in multiple precancer cases success is frequent. Unfortunately, it is actually impossible, error of criterium and certainty, to give proof of such accomplishments. The practitioner is deeply convinced of it. It is an impression valuable to himself alone.
They are very numerous in the classical homoeopathic arsenal. We shall study them very briefly by classifying them a little arbitrarily into several groups for the convenience of our work. A. The Most Habitual Remedies. These are the ones which have revealed themselves as having the most constant action on the element as well as the general state.
SEDUM ACRE and SEDUM REPENS: The value of Sedum acre was especially called to my attention by the lamented Abbe Keul. In material doses, mother tincture, IX. and 3x., it has an undeniable action on cancer in general, gives weight to the patients, and occasionally modifies the tumor, or at least retards its progress. Their principal sign is their tendency to mucosal and cutaneous fissures which are so frequent in cancer or the precancerous state. The pathogenesis of these two remedies is incomplete. Because of that we must be satisfied to use them in an empirical fashion. Sedum repens acts especially on the abdominal organs. Sedum teleplium, another plant of the same family, should act especially on the uterus or cancerous rectum with haemorrhages.
SCROFULARIA NODOSA: This remedy acts especially on cancers of breast, skin, uterus, rectum, in low potencies or material doses, especially if there is marked glandular invasion. A Nebel praised its drainage action; Cooper insisted very much on its value.
SEMPERVIVUM TECTORUM: Lingual, breast, rectal and other cancers. Its tendency to aphthae, to malignant ulcers, specially indicate it in the ulcerated cancer. It must also be used in mother tincture or low potencies.
CARBO ANIMALIS: Already studied as a constitutional remedy of great value.
CUNDURANGO: I have personally observed the value of Cundurango in oesophageal, stomach or intestinal cancers. One of its valuable external signs consists in fissures of the labial commissures. It also acts on cancer situated at the junction of mucosa and skin: lips, anus, lids. Low or middle potencies.
CISTUS CANADENSIS: This remedy acts especially in cancer of the breast, pharynx, or neck and gives rise to very marked cervical adenopathy. chronic rhino pharyngitis. Extreme sensitivity to cold.
HYDRASTIS: As good for the breast as for the stomach, Hydrastis is of great value in cancer, ulcerated or not, with progressive debility, wasting emaciation; hypochlorhydria is frequent before and during the phase of gastric cancer.
KREOSOTUM : Bleeding ulcerations, vegetations develop rapidly and emit a burning discharge, excoriating, fetid; such are the principal signs of Kreosote which acts especially well in cancer of the cervix.
ORNITHOGALUM: Already noted by Cooper, then used by Gisevius and other authors, especially in low potencies or material doses. This remedy has a remarkable action in the pyloroduodenal sphere whether it acts on an ulcer or an established cancer.
PHYTOLACCA: Here again is a remedy which must not be neglected in hard or scirrhous tumors, since it can soften and diminish them; or slightly malignant cancers which develop slowly (breast scirrhus) or on suspected tumors which have not yet degenerated (parotids). But it has several indisputable cases of cure to its credit. Syphilis is habitual among its antecedents. Low potencies. B. Remedies for Pain.
ARSENICUM ALBUM and NITRIC ACID, already studied among the constitutional remedies, dominate this group; the first with its burning pains, the second with its sensation of fine needles.
APIS continues the series; burning pricks as with red hot needles.
ARNICA: bruised pains. Especially useful in breast adenoma following traumatism. The adenoma may or may not be degenerated.
BRYONIA: amelioration through rest and strong pressure (especially for breast cancer which ought to be supported or bound).
CALCAREA ACETICA: many pains, often constrictive.
EUPHORBIUM: burning or lancinating pains, pustular ulcerations.