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Cancer of the Uterus.There is a prevalent belief, even among physicians, that the development of disease may be hastened, or even started, by the use of the imagination; and that an individual who entertains a profound dread of a given disease, and is constantly indulging his thoughts and fears with regard to his chances of becoming a victim, is more liable to acquire the disease than would have been otherwise the case. In accordance with this idea some are inclined to attribute the frequency of cancer of the womb to the general dread of the disease entertained by women whose fears lead them to attribute the symptoms of even the simplest uterine difficulties to a supposed cancer. It is not necessary to discuss here just how much value may be attached to this belief, but it is certain that the general health of many a woman has suffered seriously from her groundless anxiety as to the existence of cancer in her own person. Causes.-Imagination always riots in the attempt to explain the mysterious and unknown ; a principle of which no better illustration could be found than in the popular ideas concerning the nature of cancer. Until recently the popular explanation of cancer - as well as of all other diseases, in fact - has been that the " blood is impure." It is scarcely necessary to say at this latter day that cancer is not a disease of the constitution, not an impurity of the blood, but a local affection entirely. Another popular belief, which is shared by some medical men even to the present day, is that cancer is hereditary ; that children of parents who have had cancer are more liable than other individuals to the disease. This, too, must be classed among the exploded, or at least the unproven, beliefs with regard to this affection. It is, doubtless, true that cancer does frequently occur in individuals some of whose relatives have been also afflicted in the same way, but it is ascertained that in the majority of cases - about nine out of ten - it is impossible to discover any previous history of the disease in the family. The facts as at present known all indicate that cancer is a local disease, developed without any constitutional tendency of the individual or hereditary disposition in the family. Now, it may be asked, what is the cause? To this it may be replied that two influences are known which certainly exert a powerful effect in inducing the disease. One of these is local irritation, the other a defect in the organization of the foetus. With regard to the latter - the discussion of which would be a strictly physiological matter - nothing need be said here ; as to the former - the local irritation - it seems unquestionable that the development of cancer is favored, if not induced, in this way. It is a familiar fact that those parts of the body w'hich in both sexes are especially prone to the development of cancer, are also in nearly all cases especially exposed to mechanical irritation. Thus a common seat of cancer in man is the lower lip ; and it is the experience of every surgeon that these cancers occur with especial frequency in those addicted to the excessive enjoyment of clay pipes - the usual picture presented being a cancer on the lip corresponding in position to the hollow which has been worn into the teeth by which the pipe has been habitually held. Among women the most frequent seats of cancer are the mouth of the womb and the breast-two organs which are in the natural course of events especially exposed to local injury; among unmarried women cancer of the womb is a rarity. Yet it must be acknowledged that in a considerable number of cases of cancer this cause cannot be fairly assumed as the starting point of the disease. It seems, too, that no cause is capable of developing cancer during the earlier years of life. Cancer is extremely rare in individuals under 30 years of age, and occurs with greatest frequency between 40 and 60 years. This is true of cancer affecting the womb as well as other organs. It is also established that the disease is most frequent among women who have borne many children. Hence, every woman under 40 years of age, especially if she has not been often pregnant, should in justice to herself feel assured that she is safe from this terrible malady ; even if she have some of the symptoms which will be presently described as those of cancer ; even though there may be a tradition in her family that her grandmother's aunt had a cancer, let her dismiss at once ail fears and anxiety upon this score. Symptoms. - As a general rule, it is impossible even for the trained physician to recognize at the very onset of the difficulty a cancer of the womb, for the disease begins with the same symptoms and presents to the eye the same appearances as other affections which are not cancer. It is possible, indeed, that some of these other affections become transformed into cancer after months of existence. The first manifestations have been, indeed, already mentioned as those of other uterine complaints - pain in the back and pelvis, leucorrhcea, profuse and frequent menstruation. Thus far there is nothing characteristic of cancer ; but in a short time the patient and her friends will notice that the discharge is peculiarly offensive ; that the leucorrhcea is replaced by a bloody, fetid discharge, which often contains clots and shreds of flesh. In some cases the pain becomes a marked feature ; it is usually intermittent, being sharp and obstinate during one day for example, and then almost unnoticed on succeeding days. Pain is not, however, necessarily present in these cases. The general health of the patient always suffers and may, indeed, attract attention before the local symptoms are especially noticeable. The patient becomes weak, appetite is impaired, and indeed all the functions are performed in a way which indicate a vital failure. A usual, though not invariable characteristic of this affection is a peculiar hue of the skin, which may be best described as straw color. The patient's suspicions as to the cancerous nature of the complaint are usually first aroused by this group of symptoms - profuse menstruation, fetid discharge and beginning failure of health. In the majority of cases the physician is not consulted until these symptoms appear in other words, until ulceration has already begun. Yet it must be admitted that previous to this time it is not always possible to establish certainly the nature of the disease, and even then cases arise in which there is a possibility of doubt. Yet an examination with the finger usually decides the question. The mouth of the womb is hard, unyielding and rough, and bleeds readily upon the lightest touch. Indeed without this examination a positive decision is usually impossible, since there are several other conditions which may give rise to the group of symptoms above mentioned, including even the fetid discharge and failure of health. Among these are fibroid tumors in the cavity of the womb, polyps and severe ulcerations from other causes. Not the least common of these is the ulceration in the vagina and rectum, which occurs from syphilis. This mistake has been often made, especially since this disease may occur in women who, conscious of their own rectitude, do not conceive the possibility that they have contracted this affection. Treatment.-The only possible hope of recovery from a genuine cancer of the womb-or of any other organ for that matter- consists in the complete removal of the diseased tissue and of the healthy flesh in its immediate vicinity. It cannot be too often nor too emphatically stated that the time spent in employing less radical measures, in applying salves and pastes and plasters, is merely affording the cancer a better chance for spreading further into the body, and thus becoming utterly incurable. The history of medicine records not a single instance in which a cancer, properly socalled, was cured unless removed. There are, it is true, numerous cases in which different ulcers, falsely styled cancers by individuals who profess to cure this malignant affection, have been healed by treatment. Yet these are not cancers. The choice of means for removal must depend upon the location of the tumor and upon the extent of its ravages. Could we be sure of removing all the diseased structures, we might be confident of our power to heal the disease. In some locations - of the lip for example - the early removal of the growth is followed in most instances by entire freedom from the affection subsequently ; but in cancerous diseases of the womb an operation is not accompanied by the same assurances of success, for in consequence of the anatomical position of this organ, the disease is not detected so readily nor so early as in the former instance, and for the same reason its removal presents so many difficulties as to be but seldom followed by entire success. Yet whatever hope exists must be based upon the attempt at removal. It is not necessary to detail the measures and methods employed for this purpose ; it may suffice to say that at an early stage of the disease the necessary operation does not imperil the life of the patient, and should be always performed, since many cases are recorded in which life has been saved, or at least prolonged in comfort. In the more advanced cases the disease has usually invaded the deeper parts of the uterus as well as surrounding organs. Even in these instances a complete cure has been effected by the removal of the entire womb, though this operation has not as yet been employed with sufficient frequency to determine the chances of success offered by it. If the disease be too far advanced to warrant an operation, the treatment resolves itself into an effort to make the patient as comiortable as possible. To accomplish this, two measures are necessary : first, the use of opium to such an extent as to render the patient insensible to pain ; indeed, it may be desirable for her to become an habitual opium-eater, since thereby she secures freedom from pain and runs no danger of shortening her life. Should the patient be incapable, as some women are, of tolerating opium, some other narcotic, such as hydrate of chloral, may be substituted. It is evident that the objections which are properly urged against the use of opium in large quantities are not valid in these cases, since the patient's lease of life is at best a brief one. The other object of treatment is simply to secure cleanliness, the avoidance of odor and the repression of hemorrhage. First of all are copious injections with warm water alternating with a solution like the following : Carbolic acid, - - One teaspoonful. Alum, ----- Half a pound. Glycerine and water, - - Each one pint. Two tablespoonfuls of this may be put into a quart of warm water and used for vaginal injections three or four times a day. In addition the patient may take a warm hip-bath morning and night if the injections alone fail to secure perfect cleanliness. If the bleeding be not checked by these measures, the tampon of alum previously described may be employed to advantage. There is no hope of cure by means of medicine. The patient may, it is true, take with advantage tonics, iron and wine, merely for the purpose of increasing her strength and improving her digestion. Her diet should be bland and unirritating, though nourishing ; milk would be found of great benefit because combining all these qualities. Before the inevitable fatal termination of the case it will be found necessary to exercise tact and ingenuity in inventing measures both for the physical comfort of the patient and for sustaining her flagging strength. 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