1JAMA 100 YEARS AGO: A New Method of Treatment for Inoperable Carcinoma
of the Breast
03/21/2001; Journal of the AMA
IMPORTANT EDITOR'S NOTE: This article is dated June 15, 1901.
The industry with which the study of carcinoma is being pursued
raises the hope that we shall before long be made familiar with
its causative agent and be thereby provided likewise with the
means for its prevention and possibly also for its cure. The
attainment of these objects is especially to be desired, inasmuch
as carcinoma is one fortunately of a gradually lessening number
of diseases in the face of whose treatment the physician stands
almost hopeless and helpless.
It is true that early and adequate
surgical removal will in a gratifying proportion of cases be
attended with permanent cure, but only time can then bring assurance
that all morbid tissue and cells have been removed and that metastasis
has not already occurred and recurrence or even re-development
will not take place.
For these reasons any method of treatment,
however startling and unusual that promises amelioration, if
not cure, and does not unduly imperil the safety of the patient
should receive respectful and considerate attention, especially
if it emanate from a reputable source. A suggestion along these
lines has recently been made by Mr. Cecil H. Leaf, assistant
surgeon to the London Cancer Hospital1 with regard to treatment
of cases of carcinoma of the breast that are unsuited for operation.
He points out that with the exception of oophorectomy, conjoined
with the administration of thyroid extract, the measures heretofore
employed have had little effect in checking the onward progress
of the disease and that even by this means, although the growth
may be temporarily arrested, no permanent good is effected, signs
of renewed activity again becoming apparent after a time.
principle proposed by Mr. Leaf consists in an attempt not to
destroy the carcinoma cells, but to prevent them or the agent
that causes the multiplication from passing along the lymphatics
and invading the internal organs. For this purpose he applies
over the new-growth or the recurrent nodules a large vulcanite
shield adapted accurately to the skin and including as large
an area of surface as possible. The shield is fitted at the bottom
with a gauze India-rubber inflatable tube exactly similar to
that of an ether-inhaler, and at the surface it is provided with
a small tap to which can be adjusted any ordinary air-pump, so
that the air in the apparatus can be thoroughly exhausted. By
this means a force is provided that it is hoped will as long
as it is in action constantly restrain the noxious agent from
passing to the deeper lymphatics and thus prevent or delay dissemination.
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