“Cancer … is of colour livide or blacke, hard, and rough, eating, gnawing, and going, like unto the Crabbe-fish.”
The beast that forces us to reflect on our existence: cancer is rife – the cause of 14% of all deaths worldwide in 2008 – and the diagnosis is heartbreaking.
Awareness of cancer was much less common in the past, and nobody can say why the disease seems to have become more widespread. Is it down to improved diagnosis? To our increasing life spans? To the perversion of our food, our environment?
No doubt we have a better understanding than our ancestors, but it’s strange that cancer presents modern medicine with problems previously unknown. Have we overlooked a factor that was taken for granted by physicians in the past?
I decided to write about the treatment of this disease in Tudor times, but the material is too varied for a single post, so I’ll start with a straightforward source.
The text is by the Scots surgeon, Peter Lowe (1550-1610), from his A Discourse of the Whole Art of Chyrurgerie (1612) pp.116-118 – fourth book (On tumours in general), chapter xvi. He studied in Paris and seems to have accepted the doctrine of humoralism, although he was a critic of quacks and charlatans.
The book was first published in 1597, but this is a later edition, with reference to a case in 1603. It uses various terms for the disease, including canker, which derives through middle English from old French chancre, from the Latin cancer, for “crab”.
My transcription is from a curious gothic print, and I’m not sure of all the medical terms, so the occasional “?” marks are simple acknowledgments of my uncertainty (please follow the link to reach your own conclusions). The text uses schirrous, a greek term for “hard”, which is still used to describe tumours; I suppose the term Schir is the root.
Firstly, Lowe describes cancer and its causes:
Of Cancer, which the Greekes called Carsinoma.
Although that Cancer bee comprehended under the schirrous humors, yet there is great difference: for Cancer is a hard tumor, round, unequall, with dolour, punction and pulsation: it groweth sooner than Schir, and hath great vaines about it, tumified and swelled, full of melancholicke blood, and doth resist being prest upon. It is sometime taken for the sore of a beast, and is called Cancer, because it sticketh fast to the part as doth the Crabbe-fish to that which it taketh hold on; as also the vaines which are about are like unto Crabs feet. It is of colour livide or blacke, hard, and rough, eating, gnawing, and going, like unto the Crabbe-fish. There are two kinds of it, the ulcerate and unulcerate. The unulcerate, is called the hidden Cancer. The ulcerate, is immobill, hote by accident, through the acrimonie of terrestrious humor.
The Cause of it is a drie melancholicke humor, not onely in the part as Schir, but also in the vaines about it, the which in time becommeth sharpe and maligne, and so becommeth ulcerate: also evill dyet, and using of thinges which breed thicke corrupt blood, with such other causes, as you have heard in the chap[ter] precedent. Also the debility of the milt [?] and parts which it doth possesse, being destitute for the most part of naturall heate, and cold of themselves, as in the paps and other glandulous parts, as under the armes, in the nose, eares, roofe of the mouth, conduits of women, and fundament, feete and hands.
Lowe then describes the symptoms:
The Signes are dolour, unction, pulsation, chiefly in the night, betwixt nine and foure in the morning: in which time I have seene the sicke so grievously tormented with such intollerable paine, that it was hard to be endured. The sore is loathsome to be looked on, pale, sandy or assye [?] coloured, evill savoured, by reason of the humor which is most filthy, sordide, and stinking. It seemeth soft to looke unto, but in touching of it, it is hard, unequall, and cavernues, or hollowe: the lippes and borders are tumified and turned over, ever avoiding a virulent matter, like unto the thinne dregges of Claret wine.
The Judgements, those in the stomake, paps, head, shoulders, necke, and under the armes, be all incurable; by reason, those parts may not be cut for the great flux of blood that may easily ensue of the great vaines and artiers. Of those some are little ulcered, others much; some recent, and some inveterate; in divers parts, some are more malignant than others, and for the most part are all incurable. It hath divers denominations according to the parts it doth occupy. If it happen in the face, it is called by Vallesius Eresipelas in faciae or noli metangere. If in the legges or thighs, it is called Lupus: and if in any other part it is called Cancer.
Lowe sets out the cures, with emphasis on bleeding and nutrition:
The Cure shall first be in purging of the humor, rectifying, and drawing of blood, provoking of the hemorrhoides and monethly courses, if age permit, as also by staying the melancholicke humor from falling or setling on the part, using moderate exercise, specially before meat, sleepe onely seaven or eight houres, ever holding the belly loose, with using of good dyet, which must be cold and humide, like as broth of cooling and loosing hearbes. Abstaine from long fasting, and thinges which ingender the melancholicke humor, as is amply set downe by Galen: and all such thinges as doe heate the blood, like as salt flesh, old Hares, Venison, Harts, Goates, Vinegar, spices, cheese, mustard, fish, and sundry others of like quality; from great travaile, sadnesse, anger, melancholie, using onely one kind of meat, rysing alwayes from the table with appetite to eat more, use ever such meates as breedeth good nourishment and blood, like as Mutton, Veale, Capons, and other sort of fowles, except water fowles drinke Tysan [?], Whey, a little Ale or white Wine; that is old, mixed with Teriacke [?] and Mirridacke: also decoction of Schine [?] is good.
Finally, Lowe gives his views on cutting out tumours and the alleviation of pain, and includes a couple of case studies:
As for topicall remedies, and if it be in fit places, some do counsaile to cut it in such sort that there remaine no roote nor portion thereof: if so be, it must be taken in time before the vaines be filled with that humor, otherwise it will bee residue, as I have often remarked, for the which I will give you two examples. In Paris a gentlewoman named Madame Butrow in the yeere of our Lord God 1591. who had a Canker in her thombe, for the which I made amputation in presence of Master Marescot, and Martin doctors of Phisicke, with Leifort, and Peter Doctors of Chyrurgerie, I stayed the fluxe of blood and cured the wound soone therafter, which being closed, within 8. weekes after it brake out in the plye of her arme, and under her oxter [armpit] with such malignity and intolerable paine, that notwithstanding of all remedies as well generals as particulars shee dyed within ten weekes after. In like manner I had a Gentleman in Glascoe under my cure, in the yeere of God 1603. called James Campbell, who had a Canker in the plye of his arme, which was caused partly by the application of cold venomous remedies, by the which it did grow in short space to such bignes and corrosion, through the acrimonie of that humor, that it did both corrode vaines and artiers, with great fluxe of blood and other dangerous simptomes, for the which I did cut off the arme within three inches to the head of the Brachium, and did cure the wound perfectly. But in short time after, it brake out under his arme and in his pappe with such intolerable paine, that he lived scarce three moneths after. These two examples I thought good to set downe, that the yong Chyrurgion be not over rash in promising, before he try the nature of the disease, and the part where it is: as likewise, that all men should eschew the handes of abusers, which most commonly in all diseases doe applye colde venomous things, as was done to this Gentleman: in such cases I have ever used medicaments, refrigeratives, desiccatives, & pacifiers of pain, with such other things, as have the vertue to let the augmenting of the disease, such as the juice of Dorall, Iusqueam, Plantane, Lettice, Endive, Sorrell, Centtory, Sheepheards purse, aset a cloth in those juices and lay on the sore. Asses milke may bee likewise used, as also to be drunke by the sicke. I have oftentimes used in this, only the urin of a young male child of 5 or 6 yeers old, wet a cloth therin and apply warme to the sore as the former, by this remedy I have preserved a Nun, who had a Canker in her pap the space of 10 yeers. Petrus Hispanus doth counsaile in Cankers of the paps, to apply goats dunge with hony, which hee alleadged doth kill the Canker: also mans excrements burnt and put in powder, and applied, doth the like. Divers other remedies may be used for this purpose made of oyle of Roses, Vergie, Seruse, burnt Lead, Litharge, Pompholigos, Tuthia, Thuris, Mastick, Camphier emplaster Diapalma or Diapopholigos, certaine of those mired together, beaten in a morter of lead, and apply to the sore, doth preserve the same in one estate, also corrodeth the acrimony of the humor; the sore were so much the better if it were sometime washed with water of Cardus Benedictus. If you find that those remedies let not the augmenting of it, you must have recourse to the Chap.[ter] of Cankers and Ulcers, in the Booke of Ulcers; and so I end this Booke of Tumors in generall.
Part of Lowe’s remedies seem quackish, but I refer you to the observation of an Irish comedian: “we tried it, and the stuff that worked we now call medicine.” [link is gone – google “Dara O’Brian” + quack.]
I put more effort into that transcription than I intended, so I’ll leave it at that.
The next post on this topic will be about breast cancer.