1. Cancer is a serious disease which should receive constant medical care from the time it is first suspected.
2. “Cancer Specialists,” who advertise, should be avoided.
3. Cancer is not contagious, and there is no danger of communicating the disease to others.
4. Cancer is not a disgraceful disease, and there is no reason for being ashamed of it or hiding it.
5. As soon as cancer is suspected, whether there be a lump, or sore, or other symptoms, it should be at once cared for by a competent medical man, as the earlier it is rightly treated the more prospect there is of its being cured.
6. Anything suspected to be cancer should not be handled or squeezed, but should be kept from all irritation, as all this increases and spreads the trouble and renders the cure more difficult.
7. If it is decided that a surgical operation is desirable and wise, this should be done very completely at the earliest possible moment; delay is dangerous.
8. The proper medical treatment of cancer should never be neglected, both at the very beginning, and also long after an operation has been performed, to prevent recurrence.
9. It is not necessary to operate on every cancer; x-ray and radium are often of value, and the disease can also disappear and remain absent under careful and efficient dietetic and medical treatment alone.
10. This treatment consists in an absolutely vegetarian diet, with continuous proper medication, for a long time.
11. To get favorable results this treatment should be kept up faithfully and strictly until discontinued by the physician.
To assist in carrying out a strictly vegetarian diet, a diet list for cancer is here given, which should be closely adhered to. Coffee, chocolate and cocoa, as also alcoholic drinks, even beer, are harmful and must be avoided. The rules given at the end of this card are also to be strictly observed.
| Diet for Cancer | ||
|---|---|---|
| FIRST DAY | ||
| Breakfast | ||
| Baked apple | ||
| 4 | ounces | Rice |
| 3 | 〃 | Corn bread |
| 1¼ | 〃 | Butter |
| ½ | 〃 | Sugar |
| Hot water | ||
| Dinner | ||
| 5 | ounces | Tapioca soup |
| 3 | 〃 | Baked potatoes |
| 3 | 〃 | Stewed celery |
| 3 | 〃 | Peas |
| 1 | 〃 | Graham bread |
| 1¼ | 〃 | Butter |
| 1 | Fresh | apple |
| Supper | ||
| 4 | ounces | Boiled oats |
| 2 | 〃 | White bread |
| 1¼ | 〃 | Butter |
| 4 | 〃 | Stewed prunes |
| ¼ | 〃 | Sugar |
| Very weak tea | ||
| SECOND DAY | ||
| Breakfast | ||
| Orange | ||
| 4 | ounces | Hominy |
| 2 | 〃 | Graham toast |
| 1¼ | 〃 | Butter |
| ½ | 〃 | Sugar |
| Postum | ||
| Dinner | ||
| 5 | ounces | Pea soup |
| 3 | 〃 | Macaroni |
| 3 | 〃 | String beans |
| 3 | 〃 | Carrots |
| 2 | 〃 | Bread |
| 1¼ | 〃 | Butter |
| Dates | ||
| Supper | ||
| 4 | ounces | Cream of Wheat |
| 2 | 〃 | White bread toast |
| 1¼ | 〃 | Baked apple |
| 2 | 〃 | Crackers |
| 1¼ | 〃 | Butter |
| ¼ | 〃 | Sugar |
| Very weak tea | ||
| THIRD DAY | ||
| Breakfast | ||
| Banana | ||
| 4 | ounces | Pettijohn |
| 2 | 〃 | White bread |
| 1¼ | 〃 | Butter |
| ½ | 〃 | Sugar |
| Hot water | ||
| Dinner | ||
| 5 | ounces | Corn soup |
| 3 | 〃 | Baked potatoes |
| 3 | 〃 | Squash |
| 3 | 〃 | Boiled onions |
| 2 | 〃 | Bread |
| 1¼ | 〃 | Butter |
| Raisins | ||
| Supper | ||
| 4 | ounces | Farina |
| 4 | 〃 | Stewed figs |
| 2 | 〃 | Graham crackers |
| 1½ | 〃 | Butter |
| ¼ | 〃 | Sugar |
| Very weak tea | ||
| FOURTH DAY | ||
| Breakfast | ||
| Raw apple | ||
| 4 | ounces | Cornmeal mush |
| 2 | 〃 | Graham bread |
| 1¼ | 〃 | Butter |
| ¼ | 〃 | Sugar |
| Postum | ||
| Dinner | ||
| 5 | ounces | Vegetable soup |
| 4 | 〃 | Baked beans |
| 3 | 〃 | Cauliflower |
| 3 | 〃 | Asparagus |
| 2 | 〃 | Bread |
| 1¼ | 〃 | Butter |
| Figs | ||
| Supper | ||
| 4 | ounces | Rice |
| 4 | 〃 | Stewed prunes |
| 2 | 〃 | Graham crackers |
| 1¼ | 〃 | Butter |
| ¼ | 〃 | Sugar |
| Very weak tea | ||
| FIFTH DAY | ||
| Breakfast | ||
| Orange | ||
| 4 | ounces | Cracked wheat |
| 3 | 〃 | Corn muffins |
| 1¼ | 〃 | Butter |
| ½ | 〃 | Sugar |
| Hot water | ||
| Dinner | ||
| 5 | ounces | Sago soup |
| 4 | 〃 | Spaghetti |
| 3 | 〃 | Lima beans |
| 3 | 〃 | Boiled onions |
| 2 | 〃 | Bread |
| 1¼ | 〃 | Butter |
| Dates | ||
| Supper | ||
| 4 | ounces | Cream of wheat |
| Sliced orange | ||
| 2 | ounces | Oatmeal crackers |
| 1¼ | 〃 | Butter |
| ¼ | 〃 | Sugar |
| Very weak tea | ||
| SIXTH DAY | ||
| Breakfast | ||
| 4 | ounces | Samp |
| 2 | 〃 | Graham toast |
| 1¼ | 〃 | Butter |
| ½ | 〃 | Sugar |
| Postum | ||
| Dinner | ||
| 5 | ounces | Celery soup |
| 4 | 〃 | Baked potatoes |
| 3 | 〃 | Carrots |
| 3 | 〃 | Spinach |
| 2 | 〃 | Bread |
| 1¼ | 〃 | Butter |
| Orange | ||
| Supper | ||
| 4 | ounces | Wheatena |
| 4 | 〃 | Stewed figs |
| 2 | 〃 | Saltine biscuit |
| 1¼ | 〃 | Butter |
| ¼ | 〃 | Sugar |
| Very weak tea | ||
| Repeat this bill of fare on successive days. | ||
Some interchange of the different articles may be made according to the season and to suit the appetite or convenience of patients; but in the main this bill of fare should be followed, with occasional substitution of similar articles, if necessary.
Bread at least 24 hours old may be taken as desired.
A little old cheese may be grated on the macaroni and spaghetti, but not cooked with it.
One boiled or poached egg may be taken for breakfast every other day, and very fat bacon on the alternate days, unless otherwise directed by the physician.
It is desirable to eat the skin of potatoes, baked or boiled.
Each and every meal should be eaten very slowly, for at least half an hour, with long chewing.
One tumbler of water, not iced, is to be taken with each meal, but not when food is in the mouth; also a tumbler full of hot water, one hour before breakfast and supper.
No milk is to be taken unless specially ordered.
The vegetable soups are to be made from a stock composed of the water in which all vegetables, including potatoes, have been boiled, added to, day by day, kept hot, and allowed to evaporate; a portion is each day thickened as desired with barley, rice, farina, sago, vermicelli, etc.
The cereals are to be boiled with water, three or four hours, and may be cooked in the afternoon and re-heated in the morning, adding more water. Rice, farina, and cream of wheat require only an hour. Chopped dates, figs, raisins, or currants may be added to cereals when desired.
All the cereals are to be served very hot, on hot plates, and eaten with butter and salt to taste (not milk and sugar). They are to be eaten very slowly, with a fork, and very well chewed.
The crackers with supper may be varied to suit the taste; they should be eaten dry, with butter, and chewed very thoroughly.
Nothing should be taken between meals, unless especially directed, and the life should be as simple and healthful as possible, with early and long bed hours.
This diet list has been carefully gone over by the dietitian of the hospital, and as presented represents an average of 2,100 calories per day, with 140 of vegetable protein. This is calculated for a person of about 150 pounds, either in bed or not taking active exercise. The quantity of each article may, of course, be increased if necessary, or diminished for lighter weights, but in the main this has sufficed, so that fat persons have come nearer normal weight, while thin persons have gained in flesh. You will remember the girl of 20 years whom I showed you last week, with the right upper jaw gone after an operation for sarcoma, who weighed 89½ pounds on entering the hospital, and weighed 130½ pounds when she sat before you, three to four months later, with the opening in the cheek perfectly cicatrized on the edges, and all trace of the disease gone, on this diet.
You will notice certain directions on the last page of the folded sheet which are of importance to remember: kindly look them over carefully. I wish to call your particular attention to that in regard to perfectly chewing, masticating, or Fletcherizing the food, even cereals, for at least half an hour. Note also that the latter are to be eaten with butter and salt, and not with milk and sugar, and with a fork, and not with a spoon, in order to encourage slow eating. You will remember that in my previous lectures I called your attention to the fact that the salivary secretion was found to be at fault even in early cases of cancer, and this perfect mastication is intended to stimulate these glands and facilitate the change of starchy foods into glucose; for our rapid eating in modern days may be one of the contributing basic causes of the perverted nutrition manifested in cancer.
I would also call attention to the preparation of the vegetable soup, which is to be employed in place of the stock ordinarily used, which naturally contains the most poisonous extract of meat, or with milk, which is not desirable. This vegetable stock contains all the salts and other valuable extracts of the vegetables, which are commonly thrown away, to the great detriment to proper nutrition; there is a great loss of nutritive elements also occurring in connection with very many of the so-called refinements of food which are the result of modern civilization. Thus, the United States Agricultural Experiment Bureau tells us that thirty per cent of the nutritive value of potatoes is ordinarily wasted in the common method of peeling and cooking them. This loss of vitamines is also true in regard to wheat and other articles. You will notice that a portion of this vegetable stock for soup, made from all the water in which all the vegetables are cooked for the whole family, daily, is each day to be thickened and flavored as desired, to which also chopped vegetables may be added and also various cereals, vermicelli, tapioca, sago, etc. I may remark that many patients in private practise have told me that their families pronounced this to be the best soup they have ever tasted. Pardon all these homely remarks, but as attention to details is of the utmost importance in dermatology, so it is particularly true in regard to the management of cancer.
It will be noticed in the menu that I encourage the use of butter, giving a quarter of a pound a day, in three portions. This contains 800 calories, or one third of the total amount required; a certain amount of sugar is also prescribed, as affording an additional carbohydrate which is completely oxidized under favorable conditions.
It is realized, of course, that this bill of fare may be improved on. But it has been compiled with considerable care and thought, and an experience with it for over two years, in dozens, or rather hundreds, of cases shows that it is workable and accomplishes results which are often surprising and most gratifying, not only in my own practise but also in the hands of other physicians. I have sometimes remarked to you, perhaps thoughtlessly, that if a person had lived for three or four years according to this card, and continued to do so, I could guarantee that he would never have cancer.
So much for prophylaxis. For, as stated before, I feel confident, after many years’ observation and experience, that if the principles and practise which I have tried to present to you in my former lectures and these were closely followed by the community at large, there would before long be a very gratifying diminution in the cases of cancer, and in the mortality therefrom.
You may remember that in a former lecture I mentioned that in an extensive trip I was not able to see or hear of any cancer in the rice eating countries of the East, in Japan, China, India, Siam, and Egypt; although I understand that there is some malignant disease among the natives who adopt foreign habits, or who eat more or less meat, pork, etc. With this experience in view I have sometimes placed certain cancer patients, for a longer or shorter time, on what you are familiar with as my “rice diet,” and with manifestly beneficial results. I would not, of course, push it or continue it too long, but as a means of making an impression on a full blooded person, with beginning cancer, and as a means of facilitating the exclusion and elimination of nitrogenous elements from the system, it has sometimes served a valuable purpose. I also continually rather urge the consumption of rice by cancer patients, as largely as possible, even daily, in place of other cereals.
In regard to the medicinal treatment of cancer it is difficult to be clear and definite, and yet concise within the limits allowed for a lecture. For, as you may imagine from what has been said in these and the previous course of lectures two years ago, there is no one remedy or even any single course of treatment which is to be invariably followed or is always successful in every case of cancer.
In a disease of such uncertainty as to its definite causation, and of such obstinacy and duration from its first inception, the remedies which may be required in different cases are as varied as are the peculiarities of the individual. The treatment requires the utmost diligence and solicitous care and attention to details on the part of both the physician and patient, and over a period of time which it may be difficult to secure. This is rather a different proposition from that of a relatively brief surgical operation, after which the patient is dismissed with the hope that the disease will not recur!
Patience and perseverance, with medical acumen, are the first requisites-but before this there must be a belief and confidence in the truth of the statements, the correctness of the theory, and the value of the method to be employed; with this there must also be an optimism on the part of the physician which begets a confidence in the patient, which will do much toward reaching the desired result. Unless much time, thought, study, and effort can be given to each case of cancer, I should deprecate any attempt to treat it medically, and rather risk at once the chances of surgery, poor as they are. It was for fear of harm following an incomplete understanding of, and an imperfect or careless carrying out of the line of practise which I had pursued satisfactorily for thirty years and more that I hesitated and delayed so long before urging it generally. But the steady rise in mortality under the ordinarily accepted treatment has impelled me to strive to make clear what I conceive to be the correct view of its nature and cause, and the approximately correct treatment of cancer.
From what has preceded in these and former lectures it will be seen at once that rational and right internal treatment must proceed and continue along the lines previously indicated relating to the biochemistry of cancer. Some tissue cells have taken on wrong and rampant action, of a reproductive character, owing to an erroneous metabolism, which has induced a deranged or disordered blood current, and some measures are to be devised and carried out to restore the bodily functions to a normal state.
The first line of medical treatment, therefore, after preventing the introduction of animal protein, coffee, and alcohol by dietary measures, is to seek to restore to normal the various bodily secretions and excretions. The urine, by repeated, complete, volumetrical analysis, serves as a constant guide along many lines, which I considered pretty fully in the former lectures and need not repeat now. In one private case of cancer of the breast the total amount of urine passed each day was measured and recorded daily, almost without an exception, for a whole year, and specimens of the same were carefully analyzed and studied almost every week. The total quantity of solids, which was at first only one half what the body weight called for, was brought up to about normal as the condition of the patient improved.
It is impossible in a single lecture to tell you of all the indications and teachings which may be learned from the urine, much of which must be acquired by close observation and experience. The urea is almost always diminished, and this indicates an imperfect anabolism of the body cells, as the urea represents the final metabolism of their nitrogen. Uratic deposits are not uncommon, but other evidences of faulty nitrogenous metabolism also occur, free uric acid, ammonia, aromatic oxyacids, etc., whose individual significance in relation to cancer it is hard to trace, but clinically these derangements seem to have to do with the virulence of the disease. Indican in excess, and often greatly increased sulphates, are common, evidencing disturbed intestinal action. All these and other abnormalities, having to do with a deranged blood current, are to be rectified by proper treatment, the minor details of which cannot be elaborated in a single lecture.
I have told you that imperfect intestinal excretion and constipation are almost invariably found in the subjects of cancer, even in very early stages and long before they have been induced by opiates given for pain. I may here remark casually that even in severe inoperable cases up to a fatal ending, I seldom have to give morphin when the patients are under a full and complete line of dietary and other proper treatment; these latter seem to so change the character of the blood stream, or act in some way so that there is not the pain previously suffered. Possibly it is in part through lowering the blood pressure.
The subject of intestinal stasis or constipation is, with urinary derangement, such a very large one that it cannot be fully compassed in a single lecture. So I shall take the liberty of speaking dogmatically and shall tell you more or less definitely what observation and experience has taught me to do along these lines of faulty urinary and intestinal action in cancer. And really you will find it similar in many respects to the lines of theory and practise which I try to develop for you in connection with certain diseases of the skin. For, after all, in many conditions of disease we are to treat the patient in regard to a disordered system, and not always so much the particular disease by name. You will also remember that I have told you how it was by observing certain breast tumors which had been diagnosed as cancer by competent surgeons, urging immediate removal, disappear without operation under such treatment as I was giving for other complaints, that led me to my present point of view and practise.
In regard, then, to the actual medical treatment employed I may say that in the Skin and Cancer Hospital, and also in private practise, these patients are almost always first given a certain mixture with which you are familiar, ℞ Potassæ acetatis ℥, Tinct. Nuc. Vom. ℥ss, Extract. Cascar. fl. ℨi-ℨv, Extract. Rumicis radicis fl. ad ℥iv, the amount of cascara being varied according to the action of the bowels, which should move freely twice daily. This commonly acts also somewhat on the urine. This mixture is always taken three times daily, half an hour before eating, in one third of a tumbler of water.
It is interesting to note that Forbes Ross, a London cancer surgeon, whose untimely death has deprived us of a valuable scientific worker along our present lines, was an ardent advocate of potassium in the treatment of cancer, whose value he established on biochemical as well as clinical grounds. He, however, pushed the administration of the salts of potassium far in excess of that which I have found necessary. He has related instances of advanced cancer in which the results were remarkable, and one of them, a case of cancer of the uterus in a widow aged 59, was quite a counterpart of one which I shall narrate to you next week. I wish I could give you in extenso some of the remarkable arguments from microscopic and chemico-physiological study which he gives, to explain how potassium has such a controlling effect on cancer cells; but it is quite out of the question in a lecture such as this to enter fully into every enticing field of inquiry, and I must refer you to his valuable work. I am quite aware that when published this book was the subject of some criticism and even ridicule, but reviewers could not have properly grasped the whole book, which was simply so far ahead of the times that it was not understood. Cancer was then, even more than now, in the grip of the surgeon, who resented any thought of treatment other than by the knife.
Dr. Ross had operated much in cancer, but, realizing the inefficiency of surgery to cure the disease, he wrote very severely in regard to cancer surgery in the opening chapter of his book. After “ten years of constant microscopic, clinical and surgical research,” he advanced the hypothesis that “cancer is due to a want of balance in particular mineral salts of the body, and that the disturbance of this balance leads to the disorderly and malignant growth of epithelial cells (epiblastic and hypoblastic) which is professionally known as Cancer or Carcinoma,” and that the main disturbance is in regard to the potash balance in the body. By very careful deductive and inductive reasoning, and by actual experimentation and practise he shows how this answers and explains more of the puzzles and intricacies of the cancer problem than any other hypothesis. In the previous chapter I referred somewhat to his interesting studies on cell polarity, the red blood cells, and the probable rôle of mononuclear leukocytes in inducing cancer-genetic changes in the tissues.
Pardon this rather long reference to Dr. Ross, who was much misunderstood by his fellow practitioners because of his blunt expressions and his presentation of a new thesis regarding cancer, which was not grasped, and, as far as I know, has been neglected by the profession; his book was published in 1912, and has only rather recently come under my notice. He died the following year, but at the end of the book, three months after it was written, he added a note stating that “all the cases described therein have continued to improve under treatment, until some of them have practically ceased to be cases of recognizable cancer.”
It is, therefore, not a little satisfactory to find from a cancer surgeon such microscopic, biochemical, and clinical explanation and support for the treatment which I have followed for thirty years and more, and which I am now presenting for your consideration. Dr. Ross makes three references which in a measure support the potassium theory of cancer.
1. “The old physiological adage ‘Potassium is the salt of the tissues, and sodium the salt of the fluids of the body’ still holds good as an absolute physiological truth.”
2. “Animal physiology teaches us that the whole range of the animal creation, from an ameba to man, follows the same law, ‘Potassium is the salt of the tissue cell.’”
3. “Examination of the botanical world brings us face to face with the same identical statement ‘Potassium is the salt of the chemical physiology of the vegetable cell.’”
The first treatment, therefore, which is given to these patients is potassium acetate, as previously mentioned, in combination with nux vomica, and some cascara, and rumex fluid extract; this latter is one of the old alternative remedies which I have used for years with most favorable results in certain skin diseases. In some of the cases related two years ago and in some of those I shall report in the next lecture, this mixture, with little variation, has been employed almost from the first to the last, with occasional alternation with other remedies. Dr. Ross has used principally the citrate of potassium and phosphate of potassium combined, which he gave in doses up to 90 grains per day, and even more. I have quite recently used the same, though in smaller doses, but it is too soon to report any results, and do not know if they will serve better than the acetate, which I have so long employed. Dr. Ross makes the interesting statement that, having used enormous quantities of potash salts in his practise for fifteen years, for various complaints, not one single case of cancer had ever to his knowledge occurred amongst the clientele of his own practise, though he had constantly been engaged in operating on cancer sent to him by other medical men. I made much the same remark in one of my former lectures (p. 152), though I did not ascribe it wholly to the acetate of potassa which I have long used so freely, but to the additional normal salts which I got from a strictly vegetarian diet.
I would not have you to understand that this is all that is to be done medically for cancer patients; on the contrary, as the case goes on over a period of time, a thousand changes may be necessary to meet symptoms as they present themselves. And here arises the difficulty of making exactly plain wherein lies the successful internal treatment of cancer; for unless just the proper care is given at the right time all may not go well. For this reason these patients should be seen at least once a week, and for months, and the exact state of the system learned by volumetric analyses of the urine and occasional studies of the blood, in addition to the ordinary watching of the pulse, tongue, sleep, mode of life, exercise, fresh air, absence of worry and nerve strain, diet, etc.
Iron is a very important element in the treatment of these patients, though sometimes it will be found difficult to have it rightly taken and properly assimilated. I have come to use largely the pyrophosphate of iron in powder, in five grain capsules after meals, in conjunction with the mixture referred to, half an hour before meals. Sometimes dialyzed iron, half to one teaspoonful in water, taken in the middle of the meal, acts best, though I prefer the pyrophosphate, as phosphorus in some form should always be given for some time to these patients; it is to be remembered that the iron, potassium and other elements of the blood cells are united as phosphates. Occasionally I have to give the acetate of potassium with nux vomica and infusion of quassia after meals, in place of the other mixture, which after a while may be distasteful. But remember that potassium is the sheet anchor, and also that in some way the solids in the urine must be kept up to the standard of health, as I mentioned in a former lecture, which I occasionally accomplish by adding sweet spirits of nitre, etc.
I have emphasized imperfect intestinal action as a most important element in the probable causation of cancer, and the regulation of this function will often require the very greatest care, patience, and often even ingenuity on the part of the physician. The stools should really be frequently inspected. It is not enough to inquire at each visit if the “bowels are regular,” but the matter must be patiently investigated, as to the character, quantity, color, odor, hour of defecation, which should be after breakfast, etc. Nor is it enough just to order purgatives or laxatives from time to time, but such attention should be given, and such remedies and measures applied, as will secure the best possible performance of this most important function. The mixture just spoken of, altered as required in regard to its cascara content, will often suffice, but many of my patients also secure a full and free intestinal relief each week, by means of the old pills which you hear me order so often in this clinic: ℞ Massæ hydrargyri, Extr. Colocynth. Comp. āā gr. x, Pulv. Ipecac. gr. ii. M. Div. in capsules No. IV. Take 2 at bedtime and 2 the second night after. I also use greatly the excellent combination of ℞ Podophyllin, Cascarin, Aloin, āā gr. ¼, M. one or more of these at bedtime, as needed. I do not approve of mineral waters or saline laxatives in these cases, nor of mineral oil, and never employ enemata, except for emergencies.
I hope I have not wearied you too much with these homely details, but I assure you, gentlemen, that they are not in vain, and I only wish I could go over these and other matters yet more minutely. My experience with cancer for years has taught me well its seriousness, which I have no desire to minimize. Its dietary and medicinal treatment is no small matter to undertake, and should never be lightly entered upon. When the diagnosis of cancer has been definitely made by one or more medical men or surgeons competent to do so, the patient unfortunately is fully imbued with the very serious character of the malady, and most of them know well of the very slim chances of a permanent cure offered by surgery.
Few know, however, of the hope of a cure which can be extended to them by dietary and medical means, if they are perfectly faithful for an indefinite length of time, and if the case receives adequate and proper medical attention. It is for those of you who have heard these and the former lectures, and have seen the cases, to act with confidence and assurance, and give the utmost diligence and attention to details in order to obtain similar results; for I assure you, gentlemen, that thereby you can secure a success in cancer which is many times that following the practise of surgery, judging from the distressing and steadily rising mortality records up to the present time.
Do not be discouraged with apparent want of success at first, especially when you are treating inoperable or recurrent cases—for those are always depressing. But with more recent cases, such as I have reported in the former lectures and will mention in my next lecture, you may be pretty sure that if every feature of treatment is perfectly carried out you will attain a measure of success which is very gratifying.