Vol. 60, 1909 - University of North Carolina at Chapel Hill

306 THE CHARLOTTE MEDICAL JODKNAI .
very rare cases of this kind cures have been tliis type no matter how small might and
reported from the use of the X-rays, but all often does mean the spreading of the dis"
we can hope for, all I have ever seen these ease into the lymph or blood vessels,
rays do, is to relieve pain, and for a time As already stated I have studied closely
improve the local and general condition of the results from the X-Ray treatment and I
these patients. This improvement is not have been greatly disappointed. I have seen
seen in every case, and when it does take no permanent cures except in skin growths
place it is usually of short duration. Even and these mostly of the rodent ulcer type,
when the exposures to the X-rays were be- In other growths I have not seldom noted
gun, recurrences took place in from three improvement but this was only temporary,
to twelve months. I know that several operators have reported
I do not mean to criticise the work cures in inoperable cases of cancer. I have
of the operators, quite the contrary for not been so fortunate and in all frankness I
I know them to be men of ability who must admit that I have often met with fail"
get good results in other operative fields, ures in cases when I thought the X- Rays
but in this instance it is my firm conviction specially indicated and confidently expectthat
they attempted to cure by excision a ed good results. My technique might be
disease which is not amenable to such treat- faulty, as I have always insisted on the
ment. This view is based on the fact that avoidance of X-Ray burns and liy so doing
I am for over four years a firm believer in failed to produce the degree of skin reacthe
parasitic or infectious nature of cancer, tion uhich so many operators deem necesand,
therefore, I can't hardly see how a can- sary to obtaiii satisfactory results. That
cerous growth can be excised without gener- numbers of cures—probably the majority of
alizingthedisease through the openedlympli cures—have followed a moderate or severe
spaces, and without implanting the disease X-Ray burn there is abundant proof. But
in the freshly cut wound edges, and cause an X-Ray burn is an evidence of the delocal
recurrences. Our observation bears structive effect of the X-Rays, and I believe
these statements. The improved technique that the latter should be used to produce
and extensive surgical operations performed retrogression of the growth and not to destroy
in the last few years, have not materially it. If this is the object desired than Merimproved
the results obtained in these cases, curie Cataphoresis will accomplish it more
That this is recognized by the surgeons quickly without any danger of serious conthemselves
is I believe fully proven by their sequences. The healing will be simpler,
readiness to try other methods of treatment the scar will not be so fragile, and recurin
these cases, viz: injections of mixed tox- rence much less frequent than after an Xins,
the X-rays, serum injections of boiling Ray burn.
water and lastly a method termed "fulgu- The changes which are brought about in
ration". carcinoma either in man or in animals, by
Of course, some cases have been cured exposing them to the activities of the X-Ray
by incision, and in these cases the favorable or of radium, have been shown by Exner,
results was undoubtedly due to the fact Perthes, and others in man, and by Apolaut
that the incision was made beyond the in- and Embden and Bash ford in mice, to prefected
area, the knife at no time cutting sent exactly the same histological picture as
into the latter, and no infected cells or blood that which is presented in tumors underfrom
it comhig in contact with the fresh going spontaneous retrogression. This fact
wound. has been under observation for over a year
In nearly every case of recurrence this in Buffalo. A section of tumor retrogradtakes
place on the site of the scar resulting ing under the activity of the X-Ray or of
from the excision. The more thoroughly radium is in no way distinguishable from
this has been done, the less favorable are one taken from a tumor undergoing spontathe
chances of success from a second incis- neous retrogression or retrogression induced
ion or any other method of treatment, by serum treatment. Examination of the
When the disease recurs after a radical blood of mice which have recovered from
operation with removal of all the glands tumors through the activity of the X-Rays
draining the a£f jc;ed part, it is usually asso- shows that this fluid does not contain any
ciated or quickly followed by a general me- acquired immune factor. If however ill
tastasis. the course of treatment a mouse is heavily'
Should we not heed this significant warn- bled, the tumor will frequently begin
ing from the pathologist never to cut into a grow—a phenomenon which leads to thfei
cancerous growth even to remove a section conclusion that the X Ray does not act!
for microscopical findings unless we are directly upon the tumor, but through such
prepared to operate in event that the micro- immune factors as the mouse still possesses,
scope shows the specimen to be malignant. For this reason it would appear that the
because the mere incision into a growth of X-Ray and the radium reduce the virulence!