A THERAPEUTIC GUIDE
TO ALKALOIDAL-DOSIMETRIC-MEDICATION

By: John M. Shaller, M.D.

2nd Edition, The Clinic Publishing Co.
Chicago 1907

(Source: www.swsbm.com)

(Herewith, an extract from that publication about
topical cancer treatment . . .)

ARSENIC IN CANCER.

It seems, strange that attempts to cure cancer by means of local
applications should have almost entirely drifted into the hands of
advertising quacks. From this it may be inferred that the method is
valueless, and is used solely for pecuniary gain.

While the latter may be, largely so, yet nevertheless it is a fact
that local applications can cure cancer. `Tis true that students
received very little encouragement in this direction in the lecture
room, and medical literature is as silent on this subject as is the
lecture room.

Because quacks have so largely monopolized this method, and, have
interested themselves so much in the welfare of cancer patients,
is, no doubt, one reason why the regular profession apparently
takes such little interest in these cases.

The treatment of the sick logically belongs not only to the legally
qualified but to professionally recognized physicians, only,
however, so long as they show an interest in their patients, and
are anxious to give them the benefit of their skill and some
assurance of hope.

In proportion as, physicians fail in these reasonable and just
demands, do they compel patients to seek assistance of those who
show extreme interest and anxiety in the patient's welfare, let the
motive be what it will.

There is a very natural shrinking from the knife, and cancer quacks
offer relief without it. The knife is usually and justly advocated
by the surgeon. Late statistics by Watson Cheyne show in 111
operations a cure of 34 Per cent. These are inoperable cases,
however, and even with the operable conditions many patients will
not submit to the knife. These cases must not be abandoned.

They should interest the surgeon just as much as cutting cases.. He
should study carefully every means that offers the least hope,
principally for the benefit of the patient personally, incidentally
to prevent them from drifting into the hands of quacks.

Simply because quacks use local applications in the treatment of
cancer, should not deter the physician from using the same means.
If he uses them he does not make a quack of himself, or in anyway
even remotely connect himself with the quack.

The first question to decide is, can cancer be cured by means of
local applications? There are too many authentic cures to dispute
this. Possibly in every locality there are known cures, many of
which were performed by quacks. As humiliating as it may be, we
must acknowledge the truth that quacks sometimes cure; and if
quacks can do so, there can be no doubt that physicians can do so
even more frequently if they will but try, because of their
superior general and even special knowledge and skill.

Inspire confidence, believe in your own ability, then your actions,
your manner of speech, your determination to do and dare
cautiously, will, like an infection, inoculate others, with however
a manifold belief in your ability, greater than even you yourself
can ever hope to possess.

The chief reason why quacks thrive is that they inspire hope. They
made positive assertions backed by apparently honest testimonials.
No matter if they are all false, they are presented in such a way
as to carry conviction with them. These patients are looking for
hope and nothing that savors of the least uncertainty will do for
them. They are not, therefore, paying for knowledge or skill, for
the quack is not likely to be closely identified with either. They
pay for the hope he gives them and they usually pay well for it.

The quack does not have any secret remedy or even combination of
medicines not known to the medical profession. The only advantage
that the quack has over the physician is his boldness, possibly in
some instances downright gall. To put it more politely,
self-assurance.

What is necessary to successfully cure cancer by local remedies? A
knowledge of the medicines used. You already have this. All then
that is needed is to go ahead and use them. If your first cases are
mild ones and the locality of the cancer favorable, you will be
proportionally successful.

Select favorable cases, if possible. First impressions obtained by
using medicines are difficult to eradicate, whether they are
favorable or unfavorable.

A certain proportion of cancer cases will get well. Some will be
temporarily checked and symptoms ameliorated. Some will continue to
grow worse without at all being benefitted, just as in all
generally fatal diseases. Without medical or surgical interference,
unless some other sickness sets in, cancer may be conceded to be fatal.

This very fact should determine the surgeon more than ever to
interfere always. If the knife is impossible, then use local
applications. Some cases are cured and many others can be if the
trial is made.

REMEDIES USED.

The first class of remedies that will be considered for the purpose
of destroying cancer are escharotics. There are but two that are
worthy of consideration, arsenic and chloride of zinc.

A number of formulae that have been used extensively will be given,
not so much for the purpose of recommending them, but simply to
show what is used. Some of the combinations have been and are now
being successfully used by cancer doctors. Arsenic will be first
considered, then chloride of zinc.

HEBER'S CANCER PASTE.

Take of-White Arsenic dr. 1 
Gum Kino oz. 1 
Cinnabar oz. 1 
Hydrastis Canadensis dr. 1

Make the above ingredients into a paste with simple ointment
composed of white wax and olive oil. Apply a thinly spread layer to
the cancerous surface for twenty-four hours, or it may be rubbed on
an eruptive surface once in twenty-four hours. If the cancer is
large or covers considerable surface, the application should be
premised by preparing the system by giving sesquioxide of iron in
full doses for a few days to counteract the effect of arsenic upon
the system. 

Superficial cancers and tumors under various names which tend to
ulceration, including lupus, continue to be occasionally treated by
means of arsenical caustics. Esmarch, in the treatment of desperate
cases too far gone for the use of the knife, employed arsenic both
internally and externally, the former because the medicine is
supposed to promote the disintegration of albuminous compounds. For
the latter purpose he applied a powder compound of one part each of
arsenous acid and sulphate of morphine, 8 parts of calomel, and 48
parts of powdered gum arabic.

The powder was thickly strewn over the ulcer or wound every day,
its action was powerfully escharotic, but painless, and it
neutralized the fetor of the sore. Kaposi, after Heber, employs a
paste composed as follows: Arsenous acid gr. x, fictitious cinnabar
1-2 dram, rose water ointment 1-2 oz. "The healthy skin is not in
the least affected by it, not even excoriated, while each
individual lupus nodule is invariably and thoroughly destroyed."
Laboulbene removed epithelial tumors without severe pain by - means
of two parts of arsenous acid, 6 parts of sulphide of mercury, and
12 parts of burnt sponge, mixed and reduced by means of water to a
paste.

CANCER PASTES.

Take of arsenic, sulphur, zinc sulphate and Rochelle salts, of each
equal parts. Add yolk of egg till of the consistency of paste; bake
with slow heat until dry, and then pulverize. When desired for use,
mix again with egg and apply as paste or on cloth.

Marden's paste: Two drams arsenous acid, one dram mucilage of gum
acacia. A thick layer spread over the entire ulceration and allowed
to dry. As soon as inflammation is marked, slippery elm poultices
should be applied until it subsides. In the course of a few days
the scab comes away entirely leaving a healthy granulating surface.

To arrive at the accurate and true action of a medicine in the
treatment of disease, it must be used alone, and free from
combination with other active medicines. All extraneous adjuvants
should be eliminated until simplicity itself is reached.

Acting upon this idea the following formula and explanation is
presented as the best of the arsenic ones. It is quoted in full
because of the simplicity and lucidity of its, language.

"The radical cure of epithelioma by arsenous acid. Arsenic in
powder proving abortive, a solution of arsenous acid in equal parts
of rectified spirit and water of the strength of one part of the
acid to 150 of the menstruum employed.

The first step is to thoroughly cleanse the sore by vigorously
rubbing or scraping the raw surface, a moderate quantity of blood
being allowed to flow. The surface of the ulcer is then thoroughly
moistened with the solution, shaken up before using; and allowed to
dry, preferably without dressing of any kind. A scab forms, over
which the solution is applied daily.

The margins of the scab tend to separate from the subjacent
tissues; the treatment is continued until the scab is only retained
in place by a few loose adhesions. These are divided, the scab
removed, and a fresh application of the arsenical solution is made.
If on the following day the resulting scab is thin, of a light
yellow color, it indicates that the tissues no longer comprise any
trace of cancerous growth.

If, on the other hand, a dark colored, firm and closely adherent
scab again forms, the whole treatment must be repeated. The thicker
the resulting scab, the more energetic should be the treatment;
that is to say, the stronger should be the solution, the strength
of which may then be increased from 1 in 150 to 1 in 100 or even 1
in 10. When the desired result has been attained, there remains a
granulating wound, covered with a delicate, white pellicle, to be
dealt with on general principles."

When a scab has formed which is firmly adherent and shows little
sign of detaching itself, warm slippery elm or flaxseed poultices
may be applied for several days.

With regard to cancerous nodules without ulceration, if inoperable
and favorably situated, an ulceration may be produced immediately
over the tumor by applying fly blisters; after which arsenic is
applied to this ulceration. The nearer the nodule is to the
surface, the better the chances of success. Of course, there is
danger of poisoning when arsenic is applied to a raw cancerous
surface. This is the exception, however. If one objects to arsenic
because of the danger of poisoning, chloride of zinc may be used
without apprehension of danger from its absorption, while it
appears even more efficacious than arsenic.

Chloride of zinc enters even more frequently into cancer
prescriptions than arsenic, and some of the most famous cancer
prescriptions contain it in combination with many substances, which
of themselves have no direct influence upon cancer, yet are useful
in healing obstinate ulcerations.

The following formulae are given to show the variety of
combinations and exactly what enters into "cancer cures."

Take of chloride of zinc, pulverized bloodroot, flour, equal parts
each, and moisten with aromatic sulphuric acid; and it is sure.

I use another which will remove lupoids nicely; but notwithstanding
it is simple, it is much more severe than the former. I drain off
the white of an egg, then place the yolk in a common mortar, stir
into it all the chloride of sodium I can, and grind it to a
thorough paste. This is guaranteed to draw a man out of his boots.
I use these frequently and always with. success. Remember it is
not, "what we like, but when, where, and how."

CANCER PASTE.

The last number of your journal contained an inquiry as to how
paste to cure cancer is made. I will tell you how I have made it
for the last twenty-three years. Take equal parts (by weight) of
chloride of zinc, pulverized bloodroot, and wheat flour; mix well,
add enough water to form a paste; spread the paste just the size of
the sore on a rag and apply.

Put olive oil around the ulcer before applying in order to protect
the sound tissue. Leave the paste on as long as the patient can
bear it. Then remove and if convenient apply a mild poultice or
salve. In six or eight days the cancer will come out if it leaves
a smooth and healthy surface, all is well; if not repeat the
application until all diseased tissue is removed.

This has never failed me, but, remember that many so-called cancers
are not cancers at all. Then again, some are so malignant that this
paste and all others will not cure, but all the cases I have had,
for twenty three years were healed. One that I have on hand now, on
the lower lip of a man thirty-four years old, is stubborn, but I
hope it will finally yield.

ANOTHER. 
Take of zinc chloride gr. 5 
Alum pulv gr. 5 
Acid tannic gr. 2 
Iron persulphate gr. 3
Glycerine sufficient quantity for paste.

Mix, apply as paste or plaster.
ANOTHER.

Dr. J. B. Goodwin of Stockton, Tenn., sends the following which he
thinks came from a quack:

Take chloride zinc, pulverized bloodroot, flour, equal parts of
each. Mix and make plaster. Encircle the cancer with adhesive
plaster, spread the paste on a cloth and apply.

DR. FELL'S CANCER SALVE.
Take of zinc chloride gr. 8 
Pulv. sanguinaria rad gr. 6 
Starch gr. 8 Mix.

Apply on a piece of kid or leather.

FORMULA OF DR. LANDOLFE OF NAPLES. 

Take of zinc chloride dr. 1
Gold chloride dr. 1
Antimony chloride dr. 1
Bromine chloride dr. 1
Flour and water sufficient to form thick paste.
Spread on linen and apply to ulcerated surface.

CANCER PASTE OF ITINERANTS.

Take of zinc chloride dr. 1
Flour dr. 3
Water sufficient.

Make into paste.

LOMBARD'S CANCER REMEDIES.

Dr. J. L. Horr says in Boston Medical and Surgical Journal: Having
without solicitation on, my part become possessed of the knowledge
of the remedies employed by the late famous "cancer doctor" of
Maine. I feel it my privilege, as a member of a scientific
profession that has only for its object the advancement of
knowledge and the relief of suffering, to make a simple statement
of the remedies and methods which were employed in the so-called
"treatment of cancer."

The remedy employed, if the cancer was small, was the inspissated
juice of the leaves of the phytolacca decandra, (garget) which was
applied in the form of a plaster until sloughing took place. The
after-treatment was some simple dressing like simple cerate.

If the tumor had obtained considerable size, Dr. Lombard first used
a paste composed of chloride of zinc and pulverized sanguinaria
until an eschar was produced, and then the same plaster as before
was applied until the mass sloughed away. The knowledge of these
remedies was given to me by Dr. Lombard himself while I was
attending him during his last illness and a few days before his
death.

The above formulae and the various combinations show that zinc will
by itself do all that any of the combinations can do. When a
caustic is mixed with any bland vehicle it is rendered milder, and
its full effects are not obtained. A more accurate way is to use
the zinc alone according to Cooke, who saturated lint in the
deliquescent salt and applied the dried lint-to the cancerous
ulcer.

If this seems too strong, mix one part of chloride of zinc with one
or two parts of water. Saturate gauze with this solution and pack
it into the ulcer, or simply brush it thoroughly into all parts of
the ulcer -without any dressing whatever. This is preferable as its
action can be better observed and regulated.

No matter what strength is used, it should be thoroughly applied
and inspected each day. If any part still shows a tendency to
continue ulceration, repeat the application, using even the
deliquescent salt in those places which refuse to be checked, until
the entire mass shows healthy granulations.

The application is painful, possibly not as much so as arsenic. To
forestall this pain, a hypodermic injection of morphine should be
given, and continued as long as the pain is unbearable.

It is a poor plan to add opiates to these local applications. It is
impossible to know how much of the application will be used or how
much of the, opiate may be absorbed. When opiates are given, see
that all that is intended should enter the circulation. Do not
depend upon an uncertain amount applied with: the hope that enough
may be absorbed to relieve pain.

If severe pain is to be relieved, give enough opiates internally to
do so.

After chloride of zinc is applied the ulceration is soon covered
with a tough, dry scab, which separates in from five to fifteen
days, leaving a clean, healthy, granulating surface which,
cicatrizes rapidly. If after the scab separates there are still
places which show progressive ulceration, brush these spots over
with the deliquescent salt. If this application does not produce
healthy granulation, apply another when the scab comes away.

The fact that arteries and veins, even large ones, are visible in
the cancerous ulceration, need not deter one from using zinc
chloride even in its pure state, because it contracts and shrivels
them and prevents hemorrhage. This is a great advantage that zinc
possesses over the knife.

A surgeon might hesitate to use a knife in the vicinity of a
net-work of large blood-vessels, and possibly be could not make as
clean a dissection, whereas chloride of zinc penetrates beyond the
surface of the ulceration and no danger is likely to result from
opening up blood-vessels.

Even uterine cancer can be thus successfully treated. First
thoroughly curette the ulcer, and after bleeding has ceased, or,
even before that, as zinc is a hemostatic, its application will
check bleeding more rapidly than if left to stop. by itself. The
deliquescent salt, or one part of zinc to one or two parts of
water, may be applied on tampons, and. held in place from four to
five hours.

It is necessary to be cautious about destroying so much tissue as
to produce rectal or vesical fistula.. Use weaker solutions, in
such cases and do not permit such long contact.. If the cancer is
in the body of the uterus, occlusion may be prevented by the use of
bougies.

There is a greater feeling of safety when zinc is used than when
arsenic is used, because of the possibility of poisoning by
arsenic. As zinc seems to be even more efficacious, it should be
given the preference always. If it fails, arsenic can then be
tried.

The internal administration of arsenic is no doubt a useful adjunct
and should not be omitted from the general treatment.

For the relief of pain, the opiates are usually looked upon as
superior to other anodynes; but cicutine (conium) hydrobromate,
Abbott's, in 1-15 to 1-10 grain every two or three hours, has shown
its superiority over morphine in relieving cancer pains. This
remedy can be obtained in granules each containing 1-67 grain, from
4 to 6 being a dose. The granules are more convenient to handle and
the dose more likely to be accurate and constant, than when
prescribed for in the ordinary way.

HOW TO TREAT PATIENTS AND FRIENDS

Do not mislead the friends of the cancer patient. Tell them cancer,
without interference is generally fatal, but that many cases, even
desperate ones, are sometimes cured by local means. If the case is
not too far gone, if there is a glimmer of hope, give the patient
the benefit of it.

Tell her you will do all that medicine backed by science can do.
That there is always hope as long as the patient has strength and
hope, and a determination to get well, and is willing to let you
try. There is no case too desperate to handle, and such patients,
on account of their bravery, should receive from the physician his
utmost skill, energy and attention, for one reason among others,
that is, to prevent her getting into the hands of unmerciful
quacks. Inspire her with all the hope your conscience will allow,
and then stick to her and do the best that can possibly be done by
anyone.

When arsenic or chloride of zinc is used, it destroys the
cancer-forming property of that tissue in which the disease exists.
If all of the cancerous forming element is destroyed, whether that
element is increased cellular activity instigated by germs or by
something else, matters little, a cure is produced.

Surgeons believe that if they can successfully remove all cancerous
tissue a cure will generally be effected, which naturally leads to
the inference that cancer is local.

At any rate, arsenic and zinc destroy the rodent quality of
cancerous ulceration, which latter is transformed into a healthy
granulating surface which proceeds to cicatrization under favorable
circumstances. The smaller the ulceration, the slower the growth,
and the locality being favorable, the chances for cure are
proportionately great as these circumstances are favorable.

Report all of your cases, failures as well as cures, to medical
societies and in medical journals. Be exact in giving full details
so that everyone may understand the treatment. Take every advantage
that the profession of today allows in properly and ethically
advertising your cases.

You are doing it for the sake of humanity, for your profession as
well as yourself. And last but not least, your efforts will prevent
this class from drifting into the hands of cancer quacks. If you
have courage and push, and above all present your results properly
before the profession, you will soon receive patients from other
physicians who prefer not to handle cancer.