Chapter 5: The Diagnosis of Cancer
From my experience and observation I am of the opinion that the average physician cannot diagnose a case of cancer when it is brought to his notice. In the majority of our medical schools they teach the student that there is no cure for cancer, and that a surgical operation is the only proper thing. It is impressed on the student's mind that the right way to diagnose cancer is by use of the microscope. Instead of showing cases of cancer to the students and teaching them how to differentiate between the different forms of the disease, they have them spend their time examining pathological specimens under the microscope.
Professor Phelps of Dartmouth Medical College used to tell the students that "Pathology was looking in the ashes to find out how the building was burnt." I have learned to place very little dependence upon the microscope, as a means of diagnosis, for I have known cases of suspected cancer being examined microscopically and no trace of cancer found and yet the patient died of cancer. Elsewhere I have told the reader how to detect cancer in the system by the "eye, the tongue and the pulse." A doctor who makes a business of treating cancer is a specialist and an expert and much will be expected of him by his brother physicians, and the public at large.
He must know his specialty from A to Z. He cannot afford to make any foolish blunders. He must educate his hands -- have his eyes at his fingers' ends. The delicate, sensitive touch of the fingers will soon teach him how to detect cancer in any form in a woman's breast. By a digital examination he will learn how to differentiate cancer of the os uteri from ulceration, induration or fibroid tumor. A good deal can be learned from a study of the symptoms of cancer under the diferent forms given in other parts of this book, but very much more must be learned in the SCHOOL OF EXPERIENCE. To impress upon the reader the importance of the Diagnosis of cancer, I have appended to this Section a few cases of mistaken diagnosis.
A woman was sent to me from New York City by a medical friend to get my diagnosis of the case; she had tumors in both breasts and a bloody watery discharge from the nipple of one breast. This case had been examined under the X-Ray and the microscope, yet they could not give a positive diagnosis of the case. My diagnosis was cancer. When you have a BLOODY, WATERY discharge from the nipple of the affected side you may rest assured that it is a case of cancer.
I saw a case of cancer of the uterus that three physicians had seen and not one of them could diagnose the case. Another case which was supposed to be a fibroid tumor of. the uterus. The examining physician said it was a case of fibroid tumor of the uterus, but it had cancer cells in it. How did he know that? I have had a great many cases of cancer of the stomach. come under my observation, but I rarely find a doctor who can give a clear diagnosis of such cases. I often ask myself for what do students spend four years in a medical college if not to learn how to diagnose diseases when they see them, and to be able to cure them when met. That is what I went to a medical college for, and there I was taught practical diagnosis., by actual clinical experience, not by squinting through,a microscope,. I was taught that nearly all diseases could be cured and how to cure them by the use of remedies that have definite remedial action upon certain abnormal conditions.
There is too much guess work and uncertainty about this latter day teaching in some of our medical colleges. The text-books, many of them say you may try this, you might try that, Dr. So and So have used this or that remedy. This is all uncertainty; there is nothing DEFINITE about such instruction. Any physician who blindly follows such text-books will sooner or later lose all faith in medicine and drift out of the profession or become, as many have, a DRUGLESS HEALER.
Several years ago a man drove up to my office in a great hurry. He seemed very much excited. I enquired the cause, and he said that his physician had told him he had a cancer and of course he felt very much worried over the knowledge. Upon examination I discovered a bubo in the groin, but no cancer. A gentleman came to consult me about one of his ears, one-half of which was eaten off by some disease. He had consulted three different doctors and none of them could give him a diagnosis; yet it was a plain case of cancer. In my younger days I saw the case of a young man who had a swelling on the side of his neck. The doctor who had attended him could not tell what it was, but to satisfy his curiosity ran a probe down into the swelling. This treatment caused it to break out in a few days into an open cancer. This doctor should have learned a lesson from this case never to fool with a thing that you do not understand.
Several years ago an English doctor came over to this country to show the Yankees how to "do things." He professed to cure cancer. A case of cancer of the uterus came under his care. During the treatment the lady was confined, and the Englishman was the attending physician. When the child was born, and the afterbirth came away, he pointed to it and said: "There is the cancer; didn't I tell you I could remove your cancer?"
I was called up in New York State to see a lady who had been treated by a doctor a year for prolapsus uteri, I found her in the LAST STAGE OF CANCER OF THE UTERUS. Many physicians think it necessary to use a speculum in making a vaginal examination in cancer of the uterus, but if they had their eyes at their fingers' ends they would not need anything else to form a correct diagnosis. In all these years of my practice I have NEVER USED A SPECULUM in examining cases of this kind. It causes the patient much pain and unnecessary suffering. I was called to see an actress in New York City who had been under the care of a prominent physician in that city. He had diagnosed her case as a fibroid tumor of the uterus. She was removed to a hospital, and in the presence of several leading surgeons, he cut down upon the tumor and found it to be cancer of the uterus. The patient was sent home to die. When I saw the case it was beyond my power to render any help.
I was called to Baltimore to see a minister who had a swelling in the right side. of his abdomen. The leading doctors of that city pronounced it an abscess. They cut him open and found, not an abscess, but a CANCER ATTACHED TO THE STOMACH AND BOWELS.
A young man was brought to me with a growth on his left hip. His physician had diagnosed it as a fibroid tumor. In New York City they put him under the X-Ray to find out what the growth was. In passing may hand over the growth I said: "This is a case of sarcoma." The brother with the patient said: "That is what the doctors in New York said after they had examined him with the X-Ray."
Another case I remember was a lady in Pittsburg, Pa. She had a small bunch come in her breast. A doctor, after examining it said that he "could not tell what it was until he cut it out and put it under the microscope!" This doctor should learn to have his eyes at his fingers' ends, and then when he puts his hand over a bunch on a woman's breast, he would know by the FEELING of it just what it was. I have never been obliged to resort to the microscope to diagnose a case of cancer.
A prominent politician of Brooklyn, New York, had a swelling come in one side of his abdomen. Three physicians examined it, but said "they could not tell what it was TILL THEY CUT HIM OPEN". A day was set for the operation in New York, and a prominent surgeon at that city was to operate. I got a history of the case from a certain party, and felt satisfied that it was a case similar to the Baltimore case mentioned above. I went to the telegraph once and sent a telegram to the family that "it was a cancer, and not to have it operated on; if an operation was performed it would cause his death". The man WAS operated upon. They found the CANCER all right -- and he DIED after the operation.
The object of introducing these cases at this place is to impress upon the readers the importance of learning how to make a practical diagnosis of cancer and that much CARE must always be exercised in its attempt.