The Sun.
London, England, 1857-08-24 00:00:00

THE SURGEONS' REPORT FOR 1856.

"The accompanying statistical statement of our
labours during the past year must convince you of the
appreciatim which your charity obtains among that class
of the suffering poor this hospital:was especially insti-
tuted to assist, Year after year the number of our
applicants for relief increases ; and from,the most re-
mota parts of the United Kingdom, as well as from
America, the Mauritius, and other foreign parte, patients
journey to seek the benefits of the 'experience obtained
iu this hospital. In our 'previous reports we have re-
ferred in detail to the large accumulation of facts which,
shown forth in the statistical tables, must now be ac-
cepted as sufficient data for us to establish laws for
the guidance of the practitioner who has to treat
this malady. The average return of the disease
after operation. according to our observation in
171 cases, obtains is the ehort space of fourteen
months, and that whether the operation has been
E ffected by the knife, under chloroform without pain, or
through the protracted misery of a six weeks' cauterisa-
tion. The latter proceeding, namely, that of removing
cancerous tumours by caustics, hal been practised from
time immemorial, especially by uneducated pretenders,
eho obtain a fleeting reputation, by throwing the halo
of mystery over their proceedings, and vaunting that as
cure which is unhappily but a temporary relief, ob-
tained at the expease of the constitution, ten thousand
times more painful than amputation by the knife, and
infinitely less efficacious ie removing even the local
manifestation of the disease. If it be a cure of cancer to
remove the tumour by caustic,- it is also a cure, and an
easy one, to remove it by the knife under chloroform, and
hundreds are so `cured in all our recognised hospitals.
The legitimate professors of medicine, who know that the
assertions of such cures' are meretricious, feel them-'
selves bound to enlighten the public on this matter, and
the large experience obtained at this hospital enables us
to speak positively of the uselessness of putting patients
to the protracted torture of the treatment by caustics
where the knife can be employed. Truly, there aro
advanced cases in which caustic applications, in addition
to constitutional treatment, tend to check the progress
of the disease, but these are not generally the cases
which are undertaken by persons professing permanent
cures. Our experience leads us to the conviction that
the whole system is at fault, and that as long as en-
couragement is given to the practice of mere local
eradication no progress will be male in the treatment of
this malady. On the other hand, by constitutional
treatment, and such local remedies as experience has
suggested, we have the satisfaction of seeing very many
patients, who have been the subjects of cancer for 10 or
12 years, and patients of this hospital from its com-
mencement, restored and preserved in comparative
comfort and good bodily health. These gratifying
results are now so frequent, that we feel ourselves
bound by every possible means to bring them before the
public, and especially to invite the attention of the
medical profession t, this particular mode of arresting

the disease. .
,
" We have continued to attempt.a classification of the
cases which came before us under the heads ' Scirrhns,'-
' Epithelial,' ' Medullary,' Sc., as representing different
firms of the disease-recognised by the schools of surgery'
of
,phis country ; but as our experience becomes inure
extended, we feel the difficulty of adhering to this cls,:si-
iseation, for two reasons —viz„ that these supposed diffe
rent forms appear to us to be but stages of the same dis-
ease—the medullary, cystic, the colloid, orgelatiniform,
beingin the greater number of instances, but sequences'
of the scirrhus and epithelial forms ; so that a case tvlich
appears in our books originally as scirrhus in very many
instances must subsequently be designated medullary,
and those which would be called epithelial have many of
the characters of scirrhir.. The other reason which in-
validates these distinctions of the schools is that the
different tissues of the body, according, generally, to
their hardness, or softness, or to their exnosed or en-
closed condition, naturally allow of, or retard, the de
vejopment of the cancer ; and thus we have, in the same.
patient, scirrhus in one part, medullary in another, and

other forms in another, seen as primary deposits of the
disease, influenced thereto principally by the structure
which tke cancer has elected to attack, and, perhaps, in
some slight degree by the absence or presence of consti-
tutional power to resist disease, in whatever form itpay
arise. We need scarcely say that the popular terms,
stony cancer' and bleeding cancer,' are likewise but
representations of different epochs of the same affection ;
and, respecting the latter especially, we would earnestly
abjure the name, since its use so frequently and seriously
alarms the poor sufferer as to hasten very considerably
the fatal termination.

" As in previous reports, our statistics again show
that patients generally apply after the disease has
made considerable progress, and when, of course, the
resources of art are of less avail. It will be seen that
one-half of the number admitted have applied when
the disease had arrived at the ulcerative stage, while
the average of the duration of the disease previous
to coming to the hospital of the whole number is
three years. The descent of the disease through
families is again shown ,to exist, as has always been
believed; but, according to the evidence we have been
able to collect, only one in six of our patients could trace
the affection to an hereditary predisposition—and this, it
must be confessed, is are-assuringfact to those who may
have bad relatives thus afflicted. The average of cases
attributed to blows or other injuries is still less, being
one in seven, indicating that this is an accidental cir-
cumstance rather than a governing consequence, such
as is undoubtedly the change of constitution in females
(who form the large majority of our patients) at that pe-
riod of life at which, from our tables, it appears they be-
came the subjects of this most distressing malady. Oar
painful and anxious task of administering to the poor
clients of your bounty has often and often now, we are
delighted to say, been lightened by ,witnessing the fa-
vourable results of the principle of treatment previously
referred to. We have been enabled to send many poor.
and previously desponding sufferers to their now more
happy homes ; we have succoured all who came before
us, and we have helped to soothe and.let pass in com-
fort those whose cases were advanced beyond all human
power or control, and whose earthly career terminated
under your hospitable roof. These blessings bestowed
upon the poor of this country are due entirely to the
berality with which our directions and Prescriptions are
carried out, and we cannot be too thankful, on behalf of
our poor patients, to the committee of governors for the
confidence they show us in permitting all our orders,
whether for necessaries, comforts, or luxuries, to be ful-
filled."
STATISTICAL STATEMENT OP PATIENTS RECEIVED lIP TO
DEC. 31, 1856,

Males. Females. Total.
Ont-patients l9O 1,279 1,469
In-patients .

274 1,568 1,842
Of the out-patients discharged with disease arrested
or relieved
SITUATION OF DISEASE.
Male.
race and lip 97
Tongue 65
Special orpus 4O
Arms and hand , 5O
Bones of face
Breast
Eye
Stomach
Back
Thigh

Female.

•---
243

Females
Males

1,520

Breast
• 961.
Special organs ..
Face -
Tongue
Bye 9
Side .... . 5
Arm
Stomach and pancreas
Fauces