Cancer and its treatment: being the bradshaw lecture delivered before the Royal College of surgeons of England on december 1, 1904
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Cancer and its treatment - A. W. Mayo Robson
CONTENTS
PREFACE
INFECTIVITY
THE TREATMENT OF CANCER
PREVENTIVE TREATMENT
PREVENTIVE OPERATIONS
RADICAL TREATMENT OF CANCER
RADICAL TREATMENT OF CANCER OF THE STOMACH
PALLIATIVE OPERATIONS
Cancer and its treatment:
being the bradshaw lecture delivered before the Royal College of surgeons of England on december 1, 1904
A. W. Mayo Robson
First digital edition 2017 by David De Angelis
PREFACE
PREFACE
MR. PRESIDENT AND GENTLEMEN,
My response to your kind invitation to deliver the Bradshaw Lecture was prompted by a profound sense of the honour conferred on me; but as I began to realize the full responsibility of the step, my difficulties as to the choice of a subject sufficiently important have given me many anxious moments. In selecting the treatment of cancer I offer no apology, for no one can question the importance of the subject, or that it holds a most prominent position in the thoughts both of the medical profession and the public; moreover, I felt that such an opportunity as the present might be utilized to offer a protest both against the fatalistic tendency to delay and the senseless running after false gods in the treatment of this full disease. I cannot lay claim to being alone in my advocacy of these views, for several of my colleagues on *the Council of this College, and many other workers, have also urged them; but as a practical surgeon I can contribute facts both from my own experience and from that of others which will, I pope, help to carry the conviction that cancer, if it be discovered early and thoroughly removed, is by no means so hopeless a disease as is usually thought.
Of the true cause of cancer we really know nothing: even if we could accept the view of those pathologists who consider malignant disease as simply due to an alteration of somatic into generative elements we should be still begging the true cause; nor can we accept unreservedly the statement of the able superintendent of the Imperial Cancer Research Fund that, from the histological character, method of growth, and absence of specific symptomatology, it is not permissible to seek for the causative factor of cancer outside the life processes of the cells, for our present knowledge does not warrant such a positive statement, and it would appear from the observations of several competent pathologists that facts are not incompatible with the theory that cancer may be produced by an intracellular parasite which stimulates the cell to excessive multiplication. The fact that no parasite has been hitherto discovered is no proof that the quest is hopeless, and should be no deterrent to a continuance of research work. How many years were spent in fruitless search before Koch found the tubercle bacillus —a discovery that has placed tuberculosis on quite another platform, and one which bids fair to the stamping out of the disease! Does anyone doubt the origin of measles, scarlet fever, or syphilis from organisms? yet how much uncertainty there is! Recently Councilman has apparently proved that vaccine bodies form one phase of the life-history of the protozoon said to cause small-pox, and Dr. Roswell Park and Dr. Gaylord regard the cell inclusions in cancer as being of the same nature, though the presence of there organisms in cancer tissue is, of course, no proof that they are the cause of the disease, and the same remarks apply to Bosc's arguments and experiments on sporozoa. That bacteria are not the only possible pathogenic parasites the history of malaria has proved. We are still in almost total ignorance of some of the lòwest forms of life and of their biological peculiarities, nor are we sure that Koch's laws will be valid for them.
Until recently our ideas of the infinitely small were limited to the atom; but the atom has. been split up, and the bombardments witnessed within a Crookes tube are said to be due to the broken-up partides termed electrons, which in size are reputed to present as great a contrast to an ordinary bacterium as a bacillus does to the human body. Have we any proof that there are not organisms infinitely smaller than the smailest known micrococcus—organisms which may be ultra-microscopic, and which may be contained within the cells known as cancer cells, and be the true cause of their eccentricities? I had the privilege of seeing a microscope at the Royal Institution in April of this year which bids fair to give us a range of vision far beyond anything that Helmholtz conceived possible when he argued that from physical reasons it was impossible to construct a microscope which would give a large scale image; and experience has so far justified his conclusions that the best work has been done with magnification of from 400 to 500 diameters, yet I saw distinctly there objects under a magnifying power of xo,o0o diameters. It will help the appreciation of this point to say that the eye of the house-fly, if