PRICE, TWENTY-FIVE CENTS DIET IN TUMOR AND CANCER EPHRAIM CUTTER, M.D., LL.D. JOHN A. CUTTER, M.D., F.S.Sc. NEW YOACH^^fO&K)N 891 TO REBECCA SULLIVAN CUTTER, CASE XXVII, Wife and Mother of the writers, this essay is tenderly dedicated. Had she availed herself of the use of the knife, which removes results and not causes, she would, humanly speaking, have died; but she is a living argument, which we cannot refute or ignore, that the world progresses and that hope should never be killed in those chronically diseased. CONTENTS. Abnormal tissue subject to nutrition, p. 17, col. i. Animal food, power of, p. iS, col. ii. Appetite, conversion of, p. 19, col. ii. Baked beans, effects upon epileptics, p. 18, col. ii. Beef essence in typho-malarial fever, p. 17, col. i in cancer, p. 10, col. ii. Benevolence of the rich, need of more, p. ig, col. ii. Best conditions for cure, p. 19, col. i. Bright’s disease, food in, p. 17, col. ii. Cancer, cases of. abdominal and thoracic cavities; vertebral column, p. 14, col. ii. abdominal walls; fibro-cystic tumor, p. ir, case xxiv. breast, p. 12, case xxv. breast and chest walls, p. ir, case xxiii. breast, pseudo-cancer, p. 5, case xiii. breast, pseudo cancer, p. 6, case xiv. calvarium, heart, and liver, p. 9, case xvii. degeneration of fibroid tumor into, p. 15, col. i. eye, tissues internal angle of, pp. 6, 7, 8, case xv. fungous haematoids, p. 15, col. i. scapula, p. 8, case xvi. womb, p. 9, case xviii. womb, p. 9, case xix. womb, p. 10, case xxi. womb, p. 11, case xxii. womb, p. 12, case xxvi. womb, heart complications, p. 13, case xxvii. wrist and axilla, p. 10, case xx. Cancer. all diagnoses of, may not be correct, p. 1, col. ii. alleged cure of, by mulatto in Paris, p. 20, col. ii. alleged cure of, by quacks, p. 19, col. ii; p. 20, cols, i, ii. bioplasm with diseased impress (Beale), p. 14, col. i. case of fungous hcematoids, caused by ill-nutri- tion of poverty and orphanage, p. 15, cols, i, ii. cured by food, p. 21, col. i. definition of, p. 14, col. i. degeneration of fibroids and solid tumors into, p. 15, col. i. different types of, p. 19, col. i. Cancer. disease of malnutrition, pp. 14, 15; p. 21, col. i. early stages not a blood disease, p. 14, col. i. habits of dissipation, wrong feeding, and bad modes of life, p. 14, col. ii. has been cured by systemic treatment, p. 1, col. ii. hereditary taint, Beale’s view, p. 14, col. i. histological elements out of normal place, p. 14, col. i. hospitals of New York, p. 20, col. i. if disease of nutrition, should be attacked through food, p. 16, col. i. may be caused by loss of nerve-force, p. 18. mental depression a cause, p. 18, col. ii. more prevalent amongst ill fed, improperly fed, and abused by themselves and others, p. 15, col. i. one-half awful effect mortal terror aroused by its name, p. 1, col. ii. tissue, molecular changes in, p. 16, col. ii. tissue under malignant mob law, p. 14, col. i. training for health against disease, p. 16, col. i. treatment of, by other means than the knife, p. 1, col. i. worry a cause, p. 18, col. ii. worst word in the world, p. 16, col. i. wrong use of injection of hot water in, p. 15, col i. Consumption, food in, p. 23, col. i. Consumption and pleurisy, food in, p. 18, col. i. Cure of Cancer. alleged claims to, by quacks, p. 19, col. ii; p. 20, cols, i, ii. best conditions for, p. 19, col. i. by food, p. 21, col. i. by self-denial, faith, perseverance, pluck, de- termination, and energy, p. 19, col. i. claims of, by New York cancer hospitals, p. 20, col. i. in sanitarium, p. 19, col. i. need of means for, p. 19, col. ii. need of time, p. 19, col. ii. published claims to, p. 19, col. ii; p. 20, cols, i, ii. Destruction of the poor is their poverty, p. 19, col. ii. Diet in cancer, p. 1, col. i. VI Contents. Disease and sickness physiological mobs, p. 16, col ii. Disease, definition of, p. 16, col. ii. Epileptics, effects of baked beans upon, p. 18, col. ii. Epithelioma of tongue, galvano-cautery, p. 20, cols, i., ii. Fibroid tumors, rationale of, p. 23, col. i. Flour a poor nerve-food, p. 18, col. ii. Food. a cause and cure of fibroid tumors, p. 1, col. i. aesthetics of, p. 21, col ii. an agent of tremendous power, p. 17, col. i; p. 21, col. i. and disease, p. 16. and uterine fibroids, p. I, col. i. as a medicine in uterine fibroids, p. 1, col. i. curatively changes tissue, p. 17. definition of, p. 22, col. i. diversity of opinion upon, p. 22, col. i. ethics of, p. 21, col. ii. healthy, gives advantages over bad surround- ings, p. 22, col. ii. in Bright’s disease, p. 17, col. ii. in consumption, p. 23, col. i. in consumption and pleurisy, p. 18, col. i. in pneumonitis, p. 18, col. i. in syphilis, p. 23, col. i. in typhoid fever, p. 17, col. ii. in typho-malarial fever, p. 17, col. i. man helpless and feeble in choice of, p. 21, col. i. normal, p. 22, cols, i, ii. of mothers of nursing babes, p. 22, col. ii. Galvanism of fibroids, p. 23, col. ii. Health, standard of, p. 22, col. ii. Hope, p. 19, col. ii. How crops grow, p. 14, col. ii. Impossibilities, ethics of, p. 16. Intestines, small, organized to digest vegetable food, p. 22, col. ii. Investigations by responsible bodies under patron- age, p 20, col. i. Loss of nerve-force a cause of cancer, p. 18. Malignancy, definition of, p. 15, col. ii. Malignant disease, cure of, p. 15. Man helpless and feeble in choice of food, p. 21, col. i. Management of patients, p. 19, col. i. Mental depression, relation to cancer, p. 18, col. ii. Milk direct from gland avoids fermentation, p. 21, col. ii. Nature does the work, p. 19, col. ii. Nerve-force, loss of, a cause of cancer, p. 18. Normal food and favorable circumstances mean health, p. 16, cols, i, ii. Nutrition, abnormal tissue subject to, p. 17. Opir ion, diversity of, as to food, p. 22, col. i. Original workers, bulldozing of, p. 21, col. ii. Pastes, p. 20, cols, i, ii. Plaster jackets of Sayre, p. 21, col. i. Pneumonitis, food in, p. 18, col. i. Potatoes raised without manure, p. 14, col. i. Published claims to cure, p. 19, col. ii; p. 20. Pugilists and boat-racers, p. 22, col. i. Quackery, p. 19, col. ii; p. 20, cols, i , ii. Sickness, definition of, p. 16, col. ii. Standard of health, p. 22, col. ii. Starch a poor nerve-food, p. 18, col. ii. Stomach organized to digest meat, p. 22, col. i. Sugar a poor nerve-food, p. 18, col. ii. System sensitive to daily and hourly impressions, p. 19, col. i. Time, need of, in cure, p. 19, col. ii. Tissues of body, time of change, p. 16, col. ii. Tripe in Bright’s disease, p. 17, col. ii. Trophopathy in the fatty and fibroid degenerations, p. I, col. i. Tumor, cases of. abdominal fibroid, p. 1, case i. abdominal fibroid, p. 3, case v. abdominal fibro cystic, p. 4, case vii. abdominal fibroid, degeneration into cancer, p. 14, col. i. abdominal and uterine fibroids, p. 2, case iii. fibro-scrofulous disease of neck, p. 5, case xi. fibroid of stomach, p. 5, case viii. fibroid of womb, p. 18, col. i. fibroids c mplicating pregnancy, p. 4, case vi. multilobar fibro-myoid, p. 2, case ii. uterine fibroids, p. 5, case ix. uterine fibroids, p. 5, case x. uterine fibroids, p. 5, case xii. uterine myo fibroids, p. 2, case iv. Tumor, fibroid, rationale of, p. 23, col. i. Types of disease, different, p. 19, col. i. Typhoid fever, food in, p. 17, col. ii. Typho-malarial fever, cure of, by food, p. 17, col. i. Unrequited services of profession, p. 19, col. ii. Urine of baby nursed by a healthy mother, p. 21, col. ii. Vicarious action of organs to help others diseased, p. ib, col. ii. INDEX OE NAMES. Albany Medical Annals, p. 1, col. i. American Journal of Obstetrics, p. I, col. i; p. 2, col. i; p. 5, col. i. American Medical Association, p. I, col. i; p. 7> col. i; p. 20, col. i. Army and Navy, p. 17, col. ii. Army of the Potomac, p. 17, col. i. Beale, Dr. Lionel, p. 14, col. i. Berlin Congress, page 1, col. i; p. 13, col. ii; p. 20, col. i. Boston, p. 1, col. ii; p. 6, col. i; p. 17, col. ii; p. 20, col. i. Boston Herald, p. 20, col. ii. Bowditch, Dr. H. I., p. 4, col. i; p. 6, col. i; p. 8, col. ii; p. 16, col. i. Brown, Dr. W. S., p. 3, col. ii; p. 4, col. ii. California, p. 3, col. ii. Cambridge, Mass., p. 2, col. ii. Congress. Medical, Ninth International, p. I, col. i. Tenth International p. 1, col. i; p. 23, col. i. Connecticut, p. 20, col. i. Connecticut Agricultural Station, p. 14, col. i. Cutler, Dr., Peterborough, N. H., p. i,col. ii; p. 2, col. i. Cutter, Dr. Benjamin, p. 14, col. ii; p. 18, col. i. Cutter, Dr. Ephraim, p. 1, col. ii; p. 2, cols, i, ii; p 3, col. ii; p. 4, cols, i, ii; p. 5, cols, i, ii; p. 9, cols i, ii; p. 10, cols, i, ii; p. 11, col. i; p. 12, col. ii; p. 23, col. ii. Cutter E. & J A., p. i,col. i, p 5, col. ii; p. 11, cols i, ii; p. 12, col. i; p. 13, col. i. Cutter, Rebecca S., p iii. Dearborn, Surgeon F. M., p. 18, col. 1. Europe, p. 13, col. ii. Faraday, p. 16, col. i. Franklin, U. S. S., p. 18, col. i. Grant, General, p. 20, col. ii. Gynaecological Society of Boston, p. 5, col. ii. Gynaecology, Section of, Ninth International Medi- cal Congress, p. 1, col. i. Gynaecology. Section of, Tenth International Medi- cal Congress, p. 1, col. i. Hale, Dr. Lorenzo, p. 1, col. i. Harlow, Dr. J. M., p. 3, col. ii. Hayward, Dr. George, p. 6, col. ii. Johnson, Prof. S. W., p. 14, col. i. Keene, N. H., p. 6, col. i. Kimball, Dr Gilman, p. 4, col. ii. Liebig, p. 8, col. i. Los Angeles, Cal., p. 12, col. i. Marcy, H. O., M.D., LL.D., p. 1, col. i. Massachusetts, p. 17, col. ii. Medical Bulletin, p. 1. Medical Register, p. i, col. i. Medical Society of the State of Georgia, p. 12, col. ii. Middlesex County, Mass., p. 17, col. ii. Moore, Dr. J. M., p. 3, col. ii. New York, p. 12, col. ii; p. 20, col. i. Ninth International Medical Congress, p. 1, col. i. North Adams, Mass., p. 20, col. ii. Nunn, Prof. R J., p. 12, col. ii. Orange Judd & Co., p. 14, col. ii. Paris, p. 20, col. ii. Peabody, Mass., p. 17, col. ii. Peterborough, N. H., p. 1, col. ii. Philadelphia, Pa., p. 7, col. i; p. 12, col. i. Playfair Dr. Lyonell, p. 16, col. ii; p. 23, col. i. Riverius, Lazarus, p. 20, col. i. Sayre, Dr., p. 21, col. i. Shoemaker, Dr., p. 1, col. i. Stoneham, Mass., p. 3, col. ii; p. 4, col. ii. Storer, D. H., M.D., LL.D., p. 4, col. ii. Tenth International Medical Congress, p. I, col. i; p. 23, col. i. Tenth International Medical Congress, Berlin, Section of Gynaecology, p. 1, col. i. Thayer, Dr. W. N., p. 8, col. i. Twitchell, Dr. Amos, case of, pp. 6, 7, 8; p. 15, col. ii; p. 16, col. i; p. 21, col. ii. Vermont, p. 8, col. ii. Woburn, Mass., p. 2, col. ii; p. 3, coL ii. Wyman, Dr. Morrill, p. 2, col. ii. DIET IN TUMOR AND CANCER BY EPHRAIM CUTTER, M.D., LL.D., President American Branch Society of Science, Letters, and Art, London ; Corresponding Member Belgian and Italian Microscopical Societies; Associate Member Philosophical Society of Great Britain, etc. ; AND JOHN ASHBURTON CUTTER, M.D., B.Sc., F.S.Sc., Corresponding Member Gynaecological Society of Boston, etc. [At/ rights reserved. Copyrighted iSqz. ] HISTORICAL. IN the American Journal of Obstetrics for October, 1877, appeared an article by the senior writer, entitled “Food as a Medicine in Uterine Fibroids,” in which an effort was made to show the power of food as a cause and cure of fibroid tumors. This subject was more fully explicated before the Section of General Medicine of the American Medical Associa- tion, 1889, in a joint paper: E. and J. A. Cutter, “On Trophopathy in the Fatty and Fibroid Degenerations;” also, again, in an article by the senior writer, “ Food and Uterine Fibroids,” before the Section of Gynaecology, Tenth International Medical Congress, Berlin. In 1882, the senior writer wrote “Diet in Cancer,” and laid the manuscript aside. In 1887, the son discovered it, made a copy, and sent it to the distinguished editor of the Albany Medical Annals, Dr. Lorenzo Hale, the article appearing in the July and August numbers of that year. The father said to the son, “You have done an awful thing, because when any one talks of curing cancer by any systemic means he is called a fool or a quack.” But the reception of this paper by the profession was encouraging; it was noted editorially in the Medical Register, then edited by Dr. Shoe- maker, and, by invitation of H. O. Marcy, M.D., LL.D., President of the Section of Gynaecology of the Ninth International Med- ical Congress, a rtsumi of the article was presented to this section. It may be said, then, that the profession is ready and anxious to study the treatment of cancer by other means than the knife, and we are therefore constrained to present in this paper the histories of some of our cases of cancer and tumor that have been under our care and received diet treatment. One of two things is certain: (i) cancer has been cured by systemic treatment, or (2) all diagnoses of cancer are not correct. In either case there is hope for the sufferer. A case writes: “One-half the awful effect of cancer is in the mortal terror aroused by its name.” But we leave these general considera- tions for the second portion of this essay, and proceed to the following:— CASE HISTORIES. Case I. E. Cutter, Attendant. Tumor. A middle-aged, married lady, residing near Peterborough, N. H., was the patient of Dr. Cutler of that town. This gentleman, some years since, called my attention to this case as being a fibroid suitable for galvanism. Ac- cording to his description (and he is an intelli- gent and careful observer), the growth was hard, large, and abdominal, and of several years’ standing. There were severe and copious metrorrhagias, general malaise, exhaustion, and greatly reduced condition of general health. It is possible, but not probable, that there might have been a mistake in the diagnosis, as three-fourths of the cases of female abdominal chronic tumors are fibroids, and, when asso- ciated with haemorrhages, a much larger pro- portion. Arrangements were made with physicians and patient to visit Boston for the purpose of having galvanism applied, if deemed advisa- ble, a month later. Meantime, in order to prepare for the operation, on the principle that it is useless to apply stimuli to an enfeebled system—to give the whip when the horse needs provender—the patient was put upon a diet largely of animal food. The time of appointment came. The pa- tient did not appear. This circumstance re- (Published in The Medical Bulletin, August and September, 1891.) 2 Diet in Tumor and Cancer—Cases. ported to Dr. Cutler produced a reply like the following: “Dear Doctor, Mrs. —tried the diet faithfully, and, when the time came to go to Boston as agreed, found her tumor di- minished one-third in size, and she thought there was no need of an operation.” The writer thought so, too; pleased to find that so good a result was obtained in the brief space of a few weeks. Remained well at last accounts. Case II. E. Cutter, Attendant. Tumor. In September, 1875, a case of multilobar fibro-myoid came under my charge. The patient was 44 years of age, single, in feeble health, an invalid for many years. She had no haemorrhages, but was afflicted with consti- pation, abdominal pain, dyspepsia, and weak- ness. Menses were regular. In the right hypogastrium there was a large lobe, hard and smooth as a cobble-stone. It was the seat of a great deal of pain night and day. Two or three lobes of the same density and roundness filled the pelvic cavity and crowded the uterus up behind the pubis. In this position it was strongly retroflexed and distorted. The growth so occupied the pelvis as to leave but little spare room for the viscera. Circumstances for- bade the use of galvanism, and the strict diet was adopted, solely with a view to reduction of tumor. Being a woman of rare firmness of mind and resolute will, combined with implicit faith in her adviser, she adhered to it faithfully for the space of nine months. At this time the tumor became sensibly reduced in size in both the abdominal and pelvic portions. The pain was removed, flesh and strength improved, and altogether, for such an unpromising case, the result was mpre than could be reasonably hoped for. It was then decided, as circum- stance favored, to apply galvanism, in the hope of yet further improvement. An application of fifteen minutes’ duration was made; one electrode introduced through the abdomen and one through the rectum. Remarkable results of an unusual character followed, but as this portion of her history is foreign to the subject it will be given elsewhere. The fact of the arrest and partial reduction of the fibroid by animal diet was proven suffi- ciently by this case. (See, in connection with this case, Case xlvi, p. 304, A. M. J. Obs., April, 1887. Remarks: This case is now alive, and the tumors reduced to mere nodules. July, 1891.) Case III. E. Cutter, Attendant. T'-mor. In December, 1875, Mrs. R., of Cam- bridge, Mass., was suddenly seized with an attack of alarming copious uterine haemor- rhage. It was subsequent upon overexertion. She was 48 years old; mother of four chil- dren; small in size, pale, thin, somewhat nervous; a hard worker withal—one of those remarkable specimens of industry that would be more remarkable if not so often found in New England homes. On physical examina- tion, the abdomen was found to be occupied with several hardish lobes, somewhat painful to the touch. They were clustered about the lower part of the abdomen. There were also some suspicious lobes in the region of the liver. The vagina was found to be occupied by a large intra-uterine fibroid. The os uteri was dilated. The finger, annularly swept around the tumor, found a solid juncture between it and the uterus an inch or two within the os. The presenting surface of the fibroid was rotund, soft, spongy, and cribbed, with blind that appeared to be the points of exit for the haemorrhage. The animal diet, with quinine and tonics, was heartily adopted. Subsequently, Dr. Morrill Wyman, of Cambridge, saw the patient in con- sultation, and decidedly advised against an application of galvanism, as the case had such a malignant look. A bad issue might bring the operation into disrepute. It appeared to him more like a case of can- cer than anything else. There was much to sustain this view in the systemic and local symptoms. The strict diet was continued. The result has been an arrest of development, of haemorrhages; restoration of bloom and color of health to the cheeks. The whole general appearance had improved pari passu with the local benefits. The tumor has diminished, as evinced by the condensation and hardness of the uterine portion, by the filling up of the cul-de-sacs, and by lessened size. She attends to her duties in the household, likes her diet, and altogether enjoys better health than for many years. Her constipation is relieved by the use of St. Leon’s spring-water, an experi- ence confirmed by other cases. Her diet pre- viously had been mainly starches and sugar. 1890, alive and quite well at last accounts. Case IV. E. Cutter, Attendant. Tu?nor. Mrs. M. E. C., aged 30 years; resides in Woburn, Mass.; four children; age of young- est child, 10 months. Always enjoyed good Diet in Tumor and Cancer—Cases. 3 health. At the birth of her last child nothing was noticed out of the way with the uterus. The labor was natural and easy. January 1, 1877, she was seized with severe uterine haem- orrhages, which continued more or less up to April 1st—the date of my first visit. Found her condition one of suffering from loss of appetite, blood, color, flesh, and strength. She had been confined to her bed for sixteen days previously. Temperature of body ranged from ioo° to 1020. Cough, night-sweats, no severe chills. No physical signs of trouble with the lungs. No abdominal tumor. Rectal tenesmus, general health very bad, and run- ning down rapidly. Examination per Vaginam Os uteri pushed up under pubis. Uterine cavity 3 inches deep. Direction normal. Behind and con- tinuous with uterus, an obovoid, elastic, semi- solid, fixed mass was felt. When the sound was introduced into the uterus, it elevated the tumor by uplifting the womb. Per rectum, the tumor felt as large as the closed fist, and spongy. Diagnosis.—Myo-fibroid, because of the hsemorrhages, of attachment to and incorpora- tion with the uterine tissues, and also on the general principle that three-fourths, if not nine-tenths, of all tumors connected with the uterus are fibroid. Treat7nent.—Strict diet, quinine, ale, and aromatic sulphuric-acid baths. The question of galvanism was discussed. It was thought that it had better be deferred for the present. April4th.—Much better. Eats animal food well. Uses the Cutter invalid chair with much relief. No hsemorrhages. Advised liquor ferri persulphatis, U. S. P., should hsemorrhage recur. She thought the quinine made her sweat at night. Last night it was discontinued, and no sweats occurred. A vaginal and rectal examination confirmed the diagnosis. The tumor seemed smaller and less punky. Advised the mixed diet to be used sparingly, as a side issue, when the strict diet was dis- tasteful to the palate. April J2th.—Visited her with the battery, prepared to use it. Found the patient sitting up and dressed. Now likes her meat very much, and lives on the strict diet. Has found the chair very useful indeed. On examination, the tumor was found to be diminished one- half size. It was more compact, movable, and pointed. Temperature, 990. No medi- cine. Galvanism indefinitely postponed, as it was not needed. April 25th.—No tumor felt on palpation or seen with the speculum. General appear- ance and health very much improved. Night- sweats gone. Appetite good. Up and about the house. Walked out to my carriage to speak with my wife. Dr. W. S. Brown, of Stoneham, Mass., a skilled gynaecologist, and Dr. J. M. Moore, of Woburn, Mass., the family physician, with myself, examined the patient, and were unable to detect any tumor. General health restored. Remained so at last account, 1886. 1888.—Patient wrote from California about a pension on account of her husband, now dead. She emphasized that she was entirely well. Case V. E. Cutter, Attendant. Tumor., In August, 1875, Miss — was brought to my attention by Dr. J. M. Harlow, of Woburn, Mass., as possibly a fit subject for galvanism. She had suffered severely from haemorrhages, menstrual and inter-menstrual, so that she was blanched, thin, weak, and feeble, although she was able to be about the house. On examina- tion, the abdomen was found to be occupied, from the umbilicus downward, by a central, round, dense, and unyielding tumor. It was not very movable. There was no wave on palpation, but dullness on percussion. The uterus could be felt in the vagina, and there was no evidence of any tumor in the pelvis. From the weakened condition of the patient, it was advised not to have the operation of galvano-puncture at present, but to use the strict diet as a preliminary measure. It should be stated that her diet previously had been flour preparations mostly. The change was heartily and thoroughly adopted. It was soon followed by marked improvement. The ab- dominal hsemorrhages ceased. The appetite and strength improved. The tumor began to diminish, so that in nine months’ time from the adoption of the strict diet it could not be detected. A few months subsequently, however, by a careful examination, with all the clothing removed from abdomen, in dor- sal position, knees drawn up, a mere nodule of a little globar mass, the size of an English walnut, after some searching was discovered. Since then it has not increased. She enjoys good health, much better than for years. Pursues her occupation as clerk in an insurance officew 4 Diet in Tumor and Cancer—Cases. She adheres to the diet, and finds flour and its preparations very unpalatable and distress- ing, when forced by circumstances to partake of it. Rather than eat flour, she was known to have left a social church entertainment just before supper-time. This case has been regarded as a mere co- incidence ; but, taken in connection with the others, and the known marked improvement that almost invariably follows the adoption of the strict diet, that view is improbable. 1891, patient living, in good health, and no return of growths. Case VI. E. Cutter, Attendant. Tumor. Mrs. B., aged 34; married; no children. Father and mother died of consumption. She herself, in 1864, was pronounced by Dr. H. I. Bowditch, of Boston, to have the same disease dangerously. Still, as she came of a family that was very tenacious of life, and was of an indomitable will, she managed to live passably for most of the time on ordinary treatment. In 1872, she discovered that there was an enlargement at the lower part of the abdomen. Her physician examined and pronounced it to be due to fibroid uterine growths, that would destroy her life. In January, 1874, she came under the care of the writer, and was put on the systemic plan for consumption. In Octo- ber, 1874, she became pregnant, and as the uterus developed the tumor became more manifest, and its presence was discovered by the writer, as the patient had, from motives of false delicacy, concealed its existence. It appeared as a chain of six tumors traversing the abdomen from side to side. The skin was very thin, and the physical characters of the tumors quite prominent. The largest tumor was of the size of a goose-egg. They were moderately hard, movable, painless, and at- tached to the anterior surface of the enlarged uterus. They occasioned no trouble but from the anxiety caused by their presence. In due time a healthy, vigorous child was born, who continues so up to the present time. In two months after the birth of the child the tumors entirely disappeared, and never recurred. The mother had a plentiful lacteal secretion, and considered herself well enough to assume household and church-fair duties, against the advice of the writer and others. They killed her. This is not a hard expression; for there is no doubt, from experience derived from other cases, that, had she obeyed the instruc- tions as to exertion and duty, she might be alive, humanly speaking. Although the dissidence of the tumors was an incidental effect, still, as the strict diet is that employed for this purpose as well as for tuberculosis, the history illustrates the value of food as a medicine in the treatment of uterine fibroids. Case VII. E. Cutter, Attendant. Tumor. Mrs. Dr. W., aged about 34 years, is a healthy looking woman, of good proportion, fair size, and blonde complexion. When seen, in December, 1876, she complained of great distension of the abdomen, caused by a large tumor, which had existed seven years, and had continuously gone on without any relief from advice or treatment. For the first few years she suffered much from pain in the bowels. Now there is none. No children; though eight years married. Her general health was good, but she suffered much from the discomfort and anxiety about the abnormal enlargement of her person. On examination the abdomen was found occupied by a large, multilobar, hard, movable tumor. There was at this time no fluctuation. In the pelvis it presented the same characteristics, while it pushed the vaginal wall downward so that there was a prolapsus. The uterus could not be felt in any posture of the body. Bowels constipated. Menses pain- ful and scanty. Diagnosis, fibroid. This was the opinion of most of the physicians who ex- amined her, including her husband; Dr. Gil- man Kimball, of Lowell; and Dr. Brown, of Stoneham, Mass.; except D. H. Storer, LL.D., of Boston, who diagnosed an ovarian cyst many years before. December 6, 1876, Mrs. W. went upon the strict diet as a remedy. December 20th, re- ports abdomen diminished one and a half inches. Matters have much changed as to physical signs. Some medium-sized lobes of a semi-hard character were felt in the abdomen. On the right side there is a large fluctuating cyst extending from the cartilages of the ribs to beyond the pelvis and into the prolapsed por- tion of the posterior vaginal wall. Bimanual examination detected a distinct wave and fluc- tuation from vagina to epigastrium. This seemed inexplicable, and her husband was not convinced of there being any cyst. Still, it is history as I found it. She says the painful distension is lessened. Complains of frequent micturition and bearing down. She Viet in Tumor and Cancer—Cases. 5 dislikes her diet, yet adheres faithfully to it. Takes no other medicines. Uterus not felt. December 28th.—Has lessened two and one- half inches in size. Continues diet. Appetite good. Examined in the standing posture, the uterus can be easily felt. It was found pushed up beyond the pubis. This was the first time the uterus could be detected in my examinations during the progress of the case. May jth.—Diminished six and one-half inches. May ijth.—Is down to natural size. When last unwell, had a painless menstruation. Abdomen tympanitic throughout, except over the hypogastrium, where a movable, solid mass is felt in any position of the body. Motion communicated to uterus affects the ab- dominal tumor. Latest examination finds a still further dimi- nution. Tumor just perceptible in the centre over the pubis. For the first two weeks of diet treatment she began to grow smaller. Softening followed, and in about five weeks there was a sudden collapse in size. Notwithstanding the obscurity of some of the symptoms and the doubtful nature of the diagnosis, that might have been cleared up somewhat by the aspirator, the case is in- structive when taken in connection with the others. There was a decided, marked, and an incontrovertible change for the better. Menstruation has become painless and natural. The distress and trouble have passed away. The abdomen is no longer enlarged. The patient may practically be considered as re- stored to health. Suppose the case was a fibro-cyst combined with ovarian tumor (which no one could posi- tively tell unless gastrotomy were performed), it in no way diminished the value of the his- tory. The facts are as above stated. The report is historical to the latest sources of information. May, 1890, her husband, a physician, writes that she is well. The foregoing are quoted somewhat in full from the American Journal of Obstetrics for October, 1877, with histories to date as far as possible. The following are histories of some of our cases of tumor treated since then:— Case VIII. E. Cutter, Attendant. 1882. Mr. —, aged 60. Fibroid of stom- ach, with enlarged liver. After hard work, and by nourishment per rectum, the patient’s con- dition was so improved that he could take food by the mouth. He was cured, and remains so, April, 1890. Case IX. E. Cutter, Attendant. Woman. Unmarried. Forty years old. August, 1883. Tumor as large as an orange at fundus uteri. Anteflexion and anteversion. Double inguinal hernia. A tough case. Dieted for tumor. Wore double truss for hernia, made by C. E. Riker, of New York.; also wore Cutter stem-pessary. Result, tumor gone. Calls herself well, April, 1890; July, 1891. Case X. E. and J. A. Cutter, Attendants. Woman; unmarried. Brazilian. 1886. Im- mense uterine fibroid. Kept in abeyance by strict diet, so that she attended to her literary work. Case XI. E. and J. A. Cutter, Attendants. May, 1889. Young man, aged 18. Blood tuberculous and syphilitic. Large tumor at left side of neck, six inches long, extending from the trapezius muscle to in front of sterno-cleido- mastoid. Imbedded in the tissues of these muscles, as evinced later on. Weight, 125. Rigid diet. Biniodine of mercury; succus alterans. Salicin as needed. Londonderry lithia water locally till the tumor began to de- generate in an amyloid fashion; openings and discharge. By December, 1889, tumor had nearly gone, and sores nearly all healed. Weight, 160. This case, like many others, shows that beef is not a poison. This case was exhibited before the Gynaeco- logical Society of Boston, in June, 1890; a gentleman remarked that he had seen a similar case operated on by incision and removal; pro- cedure was very bloody, and the case died in a year of consumption of the lungs. 1891, well. Case XII. E. Cutter, Attendant. Woman, aged 40; unmarried. October, 1883. Tumor, Douglas’s cui de-sac, two inches in diameter. Kept in abeyance by diet, and if she would allow herself to rest would get rid of it. April, 1890. Case XIII. E. and J. A. Cutter, Attendants. Pseudo- Ca7icer of Breast. A married woman, aged 40, came to us in 1889 with what her physician called cancer of the breast. There was present a nodule in the right breast, 1 y2 inches in diameter; very pain- ful. Further examination revealed the case to be suffering from uterine disease, and our opinion was that the disease was a fibroid of 6 Diet in Tumor and Cancer—Cases. the breast, the pain being due to reflex causes. The tumor has entirely disappeared under diet. Case XIV. Middle-aged woman. Called cancer of breast by a dozen specialists. Had been placed on milk diet, which had done her some good. This case had uterine lesion of hyperaesthesia and displacement. Woman much relieved by diagnosis,—fibroid of breast. Do not know what outcome of her case was. Case XV. Cancer; Diet of Bread and Milk ; Cure. In the memoir of the late Dr. Amos Twitch- ell, of Keene, N. H., by Dr. H. I. Bowditch, Boston, 1851, we find the following account of his case:— “1. Cancer had appeared in his family. His grandmother died of cancer of the breast; his sister died of that of the stomach. These are all the data of his hereditary tendencies that bear upon our main topic. “2. In very early life Dr. Twitchell was in delicate health. As a youth he was stronger, and was among the foremost in all athletic sports. While at college he became dyspeptic, had jaundice, etc., and subsequently he passed gall-stones. Whilst pursuing the studies of his profession, he began to suffer from asthma, and for about twenty years was very much subject to violent attacks of it, causing him during the winter to sit up in bed half of every night. During all this period he ate animal food freely, three times a day, and digested it with ease, whereas vegetable food caused dyspeptic diffi- culties. Being induced, owing to a severe eruption of the face, to abandon this course, he gave up, for nine years, the use of meat. After some months his face was cured; and from the period at which he first aban- doned meat he never had an attack of asthma, and Dr. Twitchell considered these two facts related to each other as cause and effect. Moreover, vegetable food was soon easily borne. After the nine years of vegetable regi- men, he began gradually to resume the milder kinds of animal food, such as poultry and somewhat more of the solid meats, until two years since (1847), when he commenced the very rigid diet to be described when treating of the local disease which is the more imme- diate object of this paper. Finally, I will state, as indicative perhaps of the tendencies of the cutaneous system to morbid action, that about four years ago he had a papular eruption last- ing six weeks, and likewise that very many years ago he had a wart-like tumor on the scalp, which disappeared under the use of creasote externally applied. “3. The local disease, the course and result of which I present as the chief object of in- terest, commenced eight or ten years since as a small but hard tumor at the internal angle of the right eye. When first noticed, it was about as large as a mustard-seed, and not pain- ful. He occasionally touched it, and had some suspicion that it might eventually prove of a malignant character. It was imbedded in the substance of the skin, and from the first seemed very slowly to augment in size. At times he thought he felt some lancinating pains in it which radiated to the brow. It did not, how- ever, interfere with the functions of the lach- rymal ducts, etc. About 1843 the tumor had become nearly as large as a pea, and a tend- ency to the formation of a scab was observed. He was then induced to try some local applica- tions, and frequently, until 1845, used Jen- ning’s ointment. This would remove the scab and display three small lobes, from which exuded a little purulent fluid. At first the morbid growth seemed lessened by this and other milder applications, but no permanent effect was produced. At times the discharge ceased, but only to return again, and the tumor gradually lost its trilobed aspect. It was at this period quite conspicuous to every by- stander. 11 August, 1845.—Dr. George Hayward, of Boston, removed it with the scalpel. For a short time the wound seemed doing well, but finally it did not heal, and two months after- ward it was operated on again, and nitrate of silver was applied. Meanwhile, however, much local pain had been experienced. It was deeper-seated, less transitory, and radiated toward the brow and cheek. Sometimes it was severe enough to waken him at night, and worse usually after long journeys. “The applications during 1846-47 were chiefly of a very similar character,—cold cream, preparations of zinc, etc., and once the iodide of lead. All active applications caused inflam- mation of the eye. The tumor continued to augment slightly, and in the spring of 1847 it presented to my eye a decidedly malignant ap- pearance. It was an ulcer about the size of the top of the finger, with ragged, hard, elevated edges; and the irritation from discharge caused Diet in Tumor and Cancer—Cases. 7 the patient frequently to apply his handker- chief to the part. At night it caused a gluing of the lids and a discharge at the side of the nose. I certainly believed, and Dr. Twitchell tells me that he thought, at the time, that the disease would gradually augment and involve the eye, and he had determined, if necessary, to have this organ extirpated. His general health, as it has been already stated, continued good ; but, when not actively employed, the mind was somewhat depressed at the prospect before him. At the meeting of the American Med- ical Association, in Philadelphia, May, 1847, he consulted several of the eminent men whom he met, and I believe, I may say, that all re- garded it as a disease of a more serious nature, although some thought it might be cured by local applications, and others advised a further operation. “ Dr. Twitchell returned home discouraged, and he decided to give up all use of medicines internally, or of external applications, but to try a course of the most rigid diet. Starting from a theory that malignant diseases arise from the fact that we take too much carbon into our systems, he determined to live from that time upon a bread and milk diet; and if, at the end of some months, he did not find any diminution in the disease, he intended to use nothing but bread and water. After his return from Philadelphia he adhered strictly to the bread and milk. He used three times daily from four to six ounces of cream, or the richest milk, and same quantity of either white or brown bread. He continues that diet still (1849). “The results upon the local disease were the following : The pains in the part were lessened almost immediately. The purulent discharge very soon began to diminish, and in two or three months it was evident that the disease was not augmenting. During the following winter the improvement was more decided. In the spring of 1848, being obliged to ride over dusty roads to great distances, the eye was more irritated. Nevertheless, he felt, and his friends assured him, that the diseased part was really lessening and tending toward a cure. After that period a steady improvement took place. The ulcerated mass, which was so per- ceptible to me two years since, has wholly gone, and now (August, 1849) I can discover no difference between the angles of the two eyes, save that in the right one there is a minute white spot, about a line in diameter, looking like a scar. It is not harder than the adjacent parts; and had I not known of the existence of previous disease, I should not have noticed even this. There is no discharge, no pain, and a perfect cure seems to have been accomplished of a disease that had been exist- ing for about ten years, in a patient aged 68 years. “The effects of this rigid diet on the con- stitution, as a whole, are interesting. “Respecting his mental condition, Dr. Twitched thinks he is much less irritable than when he was omnivorous. “ He had, at one time, an attack of vertigo (to which, however, he has been always liable), and, finding that he was growing corpulent under the diet, he for a time took less of it. “ He has always been as strong as when in- dulging in a more generous diet. “ He has been able to breathe better. “His digestion has been good, but with a slight tendency to costiveness. “His organs of circulation have been un- affected. “ Renal excretion for years a little disturbed, as is not unfrequently the case in persons of his age. “Finally, Dr. Twitched presents, to my mind, the picture of a hale, robust man, in perfect health, so far as one can perceive, and but slightly touched by the influence of his many years of honorable and successful labor. “ Reflections upon Dr. Twitchell’s case :— “ i. The most important topic involved in the foregoing record is the restoration to health from what seemed to be malignant disease, and that this result followed the strict diet of bread and milk for two years. “ 2. The cessation of asthmatic difficulties, after they had troubled the patient for twenty years, and that this cure likewise followed the change of diet from an almost strictly animal diet to one quite the reverse, viz., strictly vegetable.” [Is milk vegetable food?] “3. Some readers may ask if these two cures (see following case) are not merely ex- amples of the post hoc, and they may deny that there is any complete evidence of the propter hoc. I consent to the doubt, for it has entered my own mind. Nevertheless, if mere coincidences, they are pregnant with important suggestions. I confess that, in my own prac- tice, I have never met any cases so significant 8 Diet in Tumor and Cancer—Cases. of the power which diet, simply and heroically used, has to reorganize a man. “4. Dr. Twitchell’s case becomes interest- ing as an evidence of the power of a man to subject his body to strict rule. In this epicurean age it is quite refreshing to find one who ‘ eats to live, and does not live to eat.’ A worthy professional brother of this city said, when the case was related to him: ‘ It might certainly be a question whether life were desirable under such a regimen.’ I honor a hero wherever I find him; and the heroism of Dr. Twitchell in undertaking and pursuing this course, merely in consequence of a theory, excites in me the greatest delight. In this skeptical, unbeliev- ing era, I delight to see any one having faith. “ Whether the theory was correct or not, it matters little; the fixed will of its follower arouses my enthusiasm ; and this brings me to another topic of interest. “5. The theory which governed Dr. Twitchell—was it correct? I confess that I am unable to solve the question; I merely suggest it. Some, whom I consider as our ablest chem- ists, think it was by the process of starvation, as described by Liebig, that the cure was wrought. It seems to me that this cannot be the true explanation, for Dr. Twitchell has always been stout; and it will be remembered that at one time he actually gained flesh under the diet.” Case XVI. Cancer; Diet of Bread; In- fusion of 11 Water-Dock" ; Cure. “Dr. W. H. Thayer, in a letter to me, says:— “ ‘ I have obtained from Dr. Twitchell all the particulars of the case of treatment of osteo- sarcoma which he could give me; and, as his memory is so accurate, I suppose he has not forgotten anything of importance connected with it. You know the doctor never takes notes. “ ‘ A man about 40 years of age consulted Dr. Twitchell in relation to a tumor on his scapula, as large as a pint bowl. It was evi- dently osteosarcoma, had its usual crackling feel, and resembled very closely one in the same position which Dr. Twitchell had seen a short time previously, and for which he had removed the whole upper extremity, even scapula and clavicle. In that case the wound healed, but the man died a year or two after- ward with carcinoma of some internal organ. When the second case applied for advice, Dr. Twitched declined an operation, and the man returned home to Vermont. Soon afterward he heard of somebody in New York who could cure him, and, applying to this person for ad- vice, received the following:— “ ‘ He was to take from the brook which ran through his native farm a plant which grew there (the adviser did not say what it would be), and use a weak infusion of it for his only drink every day until the tumor had disap- peared. His diet, besides this, was to consist of bread alone. This advice was strictly fol- lowed ; the plant he used was “water-dock.” Dr. Twitched happened to see the man two years afterward, when he was still following this course. He found the tumor had nearly disappeared, there being apparently only a trifling thickening of the skin.’ “These two histories must be deeply inter- esting to all. Presenting, as they do, the evi- dence of the powerful influences of diet upon the well-being of man, they are of great im- portance. I should not wish, however, to make the inference which some may be dis- posed to draw, that they prove the propriety of an almost strictly vegetable diet for all. They simply suggest that a long-continued mild and spare diet may cure when other remedies are of no avail. I am likewise well aware that, under the modern revelations given by the microscope in regard to the nature of tumors, some may doubt as to the malignant character of Dr. Twitchell’s disease. Whether it be malignant or not, I am satisfied of the truth of of the following proposition. Dr. Twitchell had a disease thought to be of a malignant character by the most eminent of the profes- sion, one of whom had once extirpated it; it had continued to augment for eight years, in spite of local treatment; and, finally, under a strict diet it began to lessen in severity, and, after a gradual improvement for a year, was wholly cured.” Dr. Bowditch writes that his practice has not embraced like experiences. Ours has. We have met with like fortitude and heroism in diet, and cannot call this age entirely epi- curean. It should be said in passing that the follow- ing cases were treated with the intention to combat the disease on grounds to be stated further on:— Diet in Tumor and Cancer—Cases. 9 Case XVII. E. Cutter, Attendant. Cancer of Calvarium, Heart, and Liver; not treated by these plans ; Death. Near Boston resides a middle-aged widow, several members of whose family died of cancer. One of them was a maternal uncle whom the writer attended in his last sickness, and made the autopsy. White, hard, distinct, globar collections of heterologous growths were found in the substance of the walls of the left ven- tricle of the heart, of the parenchyma of the liver, and of the top of the skull. Before death he used to say that he had horns growing out of his head. Spheroidal protuberances were found in the hair just above the forehead, one on each side, and one or two more back of them. At first they were thought to be atheromatous tumors, but their fixedness and rigid immobility, while the scalp moved over them, dissipated this idea. They cer- tainly appeared, as the man said, like the budding horns of a calf. A careful dissection after death showed the growths to be white, shiny, hard, spherical tumors (scirrhus), three-fourths of an inch in diameter, resting on the dura mater. After scooping them out, there appeared well-defined, circular, clean- cut holes, passing through the outer table, the intertabular substance and the inner table of the cranium, as if they had been cut with a trephine. Case XVIII. E. Cutter, Attendant. Can- cer of Womb; Diet of Animal Food, Tea and Coffee; Cure. Mrs. B., the niece of this case, had been separated for nine years from her husband by her parents, as he was an idler and would not support his family. His wife loved him, and this forced parting greatly depressed her mind. Besides, she had retroversion of the uterus. The posterior insertion of the vagina on to the uterus was the highest up of any case known to the writer, to wit, at or near the fundus. In 1876, Mrs. B. was worse. She was laboring under great mental depression from hearing that her husband was a great sufferer in Colo- rado. On vaginal examination, several hard, round tumors, somewhat matted together, were found behind the uterus. Similar, but smaller, growths were found in the enlarged cervix uteri. There were some unhealthy vaginal discharges, but they were not bloody. There was some pain, but not excruciating. The countenance had a cachectic look. There was great nervous prostration. Little ema- ciation. The Cutter retroversion pessary, which she had worn, could not be borne. Her treatment consisted of gentle laxatives, of tonics, as iron and quinine, and of a food of carefully-selected beefsteak varied with other animal food. Vegetable food was excluded, save tea and coffee. This course she faithfully carried dut, over six months after her husband’s death, with these results: The suspicious growths disappeared; she was able to wear her retroversion pessary, and at the present time she is living in the enjoyment of her usual health, with no re-appearance of the growths. I am quite ready to have a doubt thrown on my diagnosis, because of the recovery, and I will not say I could not be mistaken; but had the lady died, no one would have doubted. Perhaps our nosologies are at fault. Perhaps, also, my medical education is at fault; but if an average medical student faithfully avails himself of a four years’ pupilage in regularly chartered medical colleges, it is a hard case indeed for his instructors if they could not teach him how to diagnosticate a case of cancer of the womb. Case XIX. E. Cutter, Attendant. Can- cer of Womb; Diet of Animal Food; Opium Stopped; Iodoform Locally; Tonics and Sponge Baths of Ammonia ; Great Improvement. Discontinuance of Treat7nent; Opium Resumed; Death. Mrs. F., aged about 50 years, resided in Louisiana. In the summer she applied to me for what had been diagnosticated as ‘‘cancer of the uterus” by her local physician and by an eminent medical authority living in New Orleans. Neither gave her hope from any treatment, and she was taking opium for the relief of her pains. Physique good, though there were bloody vaginal discharges, attended with pains more or less severe. Intervals of no pain sometimes occurred. Appetite good. Found the uterine cavity normal in depth, but dense. The cervix was enlarged later- ally even to the side of the pelvis; ragged, rough, dog-bitten, and bleeding; not stony in feel, but rather punky to the touch. Just before this trouble came, one year previous, she was a subject of intense and unrelievable domestic mental difficulty on account of the actions of a relative, which shattered her nerves and made her almost distracted. 10 Diet in Timor and Cancer—Cases. She was put on an exclusive animal-food diet, varying from one article to another, as directed, one after the other, but eating mostly beef un- chopped. Twice or thrice weekly the cervix uteri was literally buried in powdered iodo- form, which was retained by absorbent cotton in the vagina. Some simple tonics, sponge baths of ammonia, visiting in different New England health resorts, and quinine and iron were prescribed. The use of opium was stopped. The effect of the treatment was like magic. The pains, the bloody flow, and the discharges ceased at once. The cervix showed less redness, thickening, and angriness of look. In the course of three months the ulcerative appearances had nearly disappeared. She thought herself cured enough to return home and to manage her case herself. Certainly the situation, so far as signs, symptoms, and feeling were concerned, coincided with her opinion, but not with mine. Against my best judgment she left. She was most strictly enjoined to continue baths and diet and have her physician apply the iodoform if there was any re-appearance of the disease. But these instructions were disregarded, and soon after her return home she grew worse, re- sumed the opiates for the annulling of pain, and after nine months died of cancer of the uterus. Had this case recovered, I suppose it would have upset the diagnosis in the minds of some. Still, it is valuable, by showing what diet, with judicious treatment, can do in the arrest of the progress of a well-authenticated case. It shows, also, the necessity of keeping one’s hold of a patient till thoroughly cured. Those who advocate “evolution of savages by degre- dation” can find many arguments for their position in the facts of the practice of medi- cine. It is easier for medical cases to run to “devolution” than to “evolution.” Case XX. E. Cutter, Attendant. Cancer of Carpal Bones and Adjacent Tissues, with Axillary Complications. Diet of Unchopped Beef, Tea, and Coffee. Am- putation at Middle Third of Forearm. Disease in Axilla Quiescent. 1891. In June, 1882, I saw at Vineland, N. J., for the first time, Mr. E. B. Osgood. He was suffering from a trouble in the palm and back of his right hand, which, in his occupation as shoe-cutter, he used all the time, and more than the left hand. Family have no taint of cancer. His hand had troubled him for thirteen months, and was much swollen and open on the dorsal surface. A probe intro- duced through the openings showed the carpal bones necrosed. On the under surface of the wrist was a curious volcanic-looking swelling, with an opening at the apex. It was about one inch and a half in diameter and one inch high. It almost touched the palm. It was boggy in feel and discharged pus. Did not look like a boil, but was malignant in appear- ance. There were in the right axilla several enlarged, stony, lymphatic glands, more or less fixed, some of which had fistulous openings and were discharging a curious flow, which, under the microscope, presented such varied and heterologous histological elements that I could not but call it cancerous. The patient was put on a diet of unchopped beef, with tea and coffee, until the condition of the general health was improved. The forearm was am- putated at the middle third by Dr. Ingram and another. A good recovery was made, and he has continued more or less strictly on the re- stricted diet ever since, and is now at present in the enjoyment of a state of health which seemed impossible before. In fact, he is called well. The local surgical attendants of Mr. Osgood regarded his case as hopeless, and publicly re- ported it as cancer. This I have from reliable testimony, independent of Mr. Osgood. Case XXI. E. Cutter, Attendant. Cancer of Womb. Diet of Beef-Essence. Great Improvement ami Arrest of Disease~ Discontinuance of Treatment. Death. In 1880, Mrs. C., of Boston, wife of an ad- vertising physician, came under my observation as a case of cancer of the womb, thus diag- nosticated by eminent medical authority. It appeared to me a case of uterine fibroid, can- cerously degenerated. She was about 35 years of age, childless, slender build, graceful form, and what was termed a “ beauty.” Her disease had lasted for about two years, if I remember correctly. She had great pain in the pelvis, profuse bloody vaginal discharges, great nervous prostration, some emaciation,, still a resolute will, and could control her ap- petite for food partly. She was able to go out a little, but with difficulty. She had an aver- sion to beefsteak and roast beef. Hence she was put on beef-essence, made by putting lean beefsteak (freed from bone and cartilage and Diet in Tumor and Cancer—Cases. 11 cut into cubes of about one inch) into a closed vessel (a common pint tin pail). This was set into a bath of cold water (a common tea- kettle), heated to boiling and kept boiling for two hours at least. The juice or essence of the meat was then squeezed out by placing it in the centre of a linen towel, gathering the four corners of the towel together and twisting the folded cloth on to the meat. No water or other fluid was added to the beef; so that the result was simply the concentrated juice. As the case was urgent, the beef-essence was pushed so that she took on some days the juice of ten pounds of beef. One result of this was diarrhoea of a profuse but painless character. It is well, in passing, to note that beef-essence in large quantities is a cathartic. Where the patient is feeble, I think this a good medicine for obstinate constipation, as the patient is not weakened thereby. Mrs. C. made a rapid im- provement. The haemorrhagic vaginal dis- charges ceased. She gained in flesh, strength, color, and looks. The pains were abated, the local disease arrested, and she rode consider- ably. But somehow a friction in management arose in which her husband came to the front and took charge of the case. The abandon- ment of the beef diet was followed by a return of all bad symptoms, and in the course of a few weeks she died of the cancerous disease. Had this patient continued, I should have tried to have her go on to eat solid beef pre- pared with a chopper. Though this is an unfavorable case, still it shows what full feeding on beef will do some- times in a case undoubtedly cancerous. Case XXII. E. Cutter, Attendant. Cancer of Womb. Diet of Beef, Tea, Coffee, and Milk. Cure. Mrs. C., of Somerville, Mass., was a sister of Case XXI. Soon after the death of her sister, Mrs. C. applied for examination to see if she had the same trouble. Her mental condition was bad, circumstances limited, and countenance cachectic. There was some vaginal discharge, not bloody, and also some pain in the uterus. These things made her apprehensive and anxious. An exploration of the vagina showed knobbed enlargements of the os and cervix uteri, dense and stony, not ulcerated. The trouble was confined to the neck of the womb. She was put on an exclusively animal-food diet, adding tea, coffee, and milk. She was faithful to the extreme, perhaps because she knew the situation perfectly. The result was that the diseased appearances de- parted, and she is at the present time looking and feeling well. January, 1891, apparent return of disease, but in stomach; womb normal. July, 1891, reported as quite well after going back to old diet. The local physician had diagnosticated cancer. Case XXIII. E. and J. A. Cutter, Attend- ants. Cancer of Breast. Uterine Dis- ease and Consumption of Bowels. Madame —, aged 65, occupation gentle- woman. Came under our care February, 1889. Had a small growth in left breast, uterine hypersesthesia and displacement, and chronic diarrhoea; also a sessile cancerous tumor in right chest-wall above breast, and one in right popliteal space, both of which were removed by galvano-caustic at the outset of treatment by Cutter electrode and battery. She was carefully treated for her uterine trouble with iodoform in capsules and vector, and has worn at two different times a Cutter stem- pessary for nearly two years. The condition of the bowels is much improved. Disease of left breast reduced; though slightly increased July, 1891. Axillary glands on same side no longer swelled. While this case wishes that the growth was gone, yet she is satisfied that it is reduced, instead of increasing. No return of disease in right popliteal space and right chest. Case XXIV. E. and J. A. Cutter, Attend- ants. Tumor and Cancer. Death. Madame —, aged 65. January, 1889, the senior writer found her sick in bed with peri- tonitis, and her relatives waiting for her to die. On the subsidence of the inflammation it was found that she had growths in the abdominal cavity which were large, involving the womb, hard and soft, evidently fibro-cystic. They extended to above the navel. She went on to systemic plans of diet, with the result of im- provement so that she could go to New York, and was “going to get well.” Still, the case looked ominous, and the possibility of cancer was suggested. In May she became somewhat straitened in funds and stopped doctoring, but followed up the plans. This was a mistake, for in the fall we found that she was anxious to be treated, but feared to incur a bill. The case was, how- ever, looked after. In the spring of 1890 it 12 Diet in Tumor and Cancer—Cases. was decided to apply galvanism by profound abdominal puncture. This was done twice under anaesthesia. The result was the dimi- nution and softening to a large extent of the growths in the lower part of the abdomen. But the stringency in her money matters did not abate; she became greatly worried, indeed was pushed for ready money for the very necessaries of life; her appetite weakened; she complained more of stomach and gradually wasted. Died in October, 1890. A hurried post-mortem was made by the junior writer, assisted only by a layman. The disease in lower part of abdominal cavity was about gone. The intestines were matted by inflammatory products. In the left side was found a hard mass, which was imbedded in the muscles and encroached upon the stomach. A section placed under the microscope showed it to be epithelioma. It was later ascertained that she had broken two ribs a number of years ago, and that more than ten years ago she had consulted a surgeon in Philadelphia for advice. The history of this case makes us think that if she had been well supplied with money the disease in the side would have kept in abeyance, for she was a woman of remarkable fortitude and strength of mind. Case XXV. E. and J. A. Cutter, Attend- ants. Cancer of Breast. Cure. A woman, aged 64, living in Los Angeles, Cal., consulted us by letter over a year ago, stating that she had had a growth in her breast that her physician, a regularly educated and graduated practitioner, diagnosticated as cancer. She then fell into the hands of some one who took her cancer out by pastes, leaving an open sore, “as large as an orange,” that would not heal. Under systemic plans of diet and medica- tion, followed up by examinations of urine and faeces sent by mail, this case so improved that the trouble in her breast healed. On May, 1891, the patient was examined at our sanitarium to see what was the cause of a vaginal discharge. It was found that her pelvis was packed with a hard fibroid. The breast had healed in a beautiful white cicatrix. Now, this case may not have been cancer; but trouble of that kind in the breast, at her age, is usually seriously regarded. Case XXVI. E. Cutter, Physician. Can- cer of Womb. Diet of Chopped Beef * and Hot Water. Mild Systemic Tonics. Iodoform and Carbolic Acid Locally. Cure. In January, 1882, Miss W., a middle-aged clerk, was discharged from a hospital in one of our large cities to die of malignant disease of the uterus. The gentleman of the staff who discharged her has given a diagnosis confirm- ing the above statement. Prof. R. J. Nunn, M.D., ex-President of the Medical Society of the State of Georgia, at my request, examined her subsequently, and confirmed the diagnosis. I mention these things because I treated her without seeing her She suffered with profuse vaginal discharges, which were sometimes bloody and always offensive, until the use of iodoform removed the fcetor. The uterus was enlarged, the cervix stony, with considerable ulceration and excavation. She was conscious of her situation, and understood the diagnosis. Although placed in unfavorable circumstances, and devoid of her family’s sympathy in the undertaking, with a heroism worthy of Dr. Twitched, she went on to a diet of chopped beef (cooked) and hot water. Systemic tonics of a mild character were administered. Iodo- form and carbolic acid were used locally. Mor- phological examinations of the urine, faeces, and vaginal discharges, once or twice a week, furnished me the means of keeping her up strictly to the plans. She remained on treat- ment over a year. From time to time other patients of mine told me of the marked im- provement in her case. They said her general appearance was so much bettered they hardly knew her. From being confined to her bed, she became well enough to attend church and go out to walk daily. In the summer of 1884, she visited me at my office in New York, and I saw her for the first time. Her appearance was that of perfect health, and she claimed to be in that con- dition. However, on examination, I found the uterus enlarged—about the size of a child’s head. There was no ulceration or discharge, and I thought that if she was able to carry this enlarged uterus without any trouble I ought to be satisfied with the results. 1887, January 3.—Examined at office. I found by bimanual examination no enlargement of uterus. Os uteri normal, or nearly so. * We never prescribe beef raw, whether chopped or not. Diet in Tumor and Cancer—Cases. 13 Some vaginal discharge. Appearance that of perfect health. Patient still alive in June, 1891. Is a clerk. Case XXVII. E. Cutter, Attendant. Can- cer of the Uterus, with Serious Heart Complications. Fed Against the Appe- tite with Tenderloin Steak, Broiled. Result: Cure of Uterine and Cardiac Lesions.* Some years ago a middle-aged mother of a large family lay sick in bed of great grief at the loss of her last daughter, who died under peculiar circumstances, f There were present cardiac hypertrophy and insufficiency of the left auriculo-ventricular valve; severe attacks of angina pectoris, when it seemed that death was near. The objective lesions, other than those named, were retroversion, engorgement, hard- ening, eversion of the os uteri, and behind the uterus four small, hard, marble-like tumors: very severe pain, sharp and stinging, in the pelvis mostly; profuse vaginal discharge, not bloody; menorrhagia. Added to this there was loss of appetite so complete that everything in the nature of food was loathed, even milk being repulsive; loss of flesh and strength, being unable to rise erect for ninety days; in- ability to lie on either side for most of the same time; nausea; legs cold and sweaty up to the knees; ofttimes great stomach distress, with wind colic; urine high colored and of rank smell, as if putrid; bowels constipated; a ter- rible feeling of nervous restlessness, causing her to move her feet rapidly up and down in the bed; visitors coming and assuring her by their looks and actions that she was about to die. Added to this there was cancer in her family, her father having died of cancer of the stomach and a maternal grandmother of cancer of the breast. She was put on general and local treat- ment, and it was faithfully carried out in con- nection with good nursing; but she gradually grew worse, until at the expiration of three months the symptoms were so alarming that I was obliged to take strong and decisive grounds, and to tell her: “You must eat, or die of can- cer of the womb. Make up your mind to one or the other.” She decided to live and eat, eating against her appetite, but with her intel- lect and reason and the advice of her medical attendant. She began with tenderloin steak, broiled and cut up very fine. The most she could take at first was a quantity represented by two teaspoonfuls; this she swallowed by a desperate effort, her stomach rising against it. She was fed thus every four hours. Even after she had fed thus for weeks she felt she would rather die almost than eat, but battled against appetite by sheer force of will. The only way she could get down the beef was by swallowing one mouthful of lager beer, which was the only article that did not go against the stomach. The quantity of meat was increased gradually, and she was fed two months against her appe- tite. The nausea, however, left in about three or four weeks, and at this time she was able to move some, and was placed in a Cutter invalid chair part of the day. After two months of feeding, she was taken carefully to the seashore, and there she began to get an appetite, but it took one year before she could walk five hundred feet. Visited Europe 1889 and 1890, and stood the excitement and fatigue of the great Berlin Congress well. Is the joy and delight of her husband and family, and a living argument that cannot be ignored. No person could have eaten so thoroughly against the appetite as this case did, and it was only from fear of death by cancer, whereof her father died, that made her struggle for life with all her powers. It was not death she feared, but the form, from which she revolted with horror. This is rather difficult to understand, but it is none the less true. Results.—1. Heart normal in size. 2. Valvular insufficiency hardly perceivable. 3. Angina pectoris gone. 4. Uterine disease relieved, tumors disap- peared, uterus mobile, discharges normal. 5. Urine clear as champagne, 1015 to 1020 specific gravity; no odor; no deposit on cooling. 6. Restoration to active duties in her position as housekeeper and mother of the family. No medicine was given after the food treat- ment, save Hoffman’s anodyne when she had palpitation of the heart and suffocation of breath; the severe, agonizing pain left soon after the diet was begun. This case is the wife of senior writer, alive and well July, 1891. * See Case III, “ Feeding Patients Against the Appetite,” Medical Register Philadelphia, April 2 and 9, 1887. f This daughter died after a few days’ illness, from the results of the perforation of the appendix caeci by an orange-seed. 14 Cancer a Disease of Mal-nutrition. WHAT IS CANCER? THEORETICAL CONSIDERATIONS. Cancer means “ Crab," and is, in our opinion, tissue under malignant mob law, mai?ily due to defective nutrition. Here it will be proper to show the reasons why cancer is called a disease of nutrition, as this is a vital point in our argument, and then we shall point out the ways in which it may be possible for food to modify cancerous condition. Reason I. Cancer, except in its last stages, is not a disease of the blood, so far as the writer can learn by morphological blood ex- aminations for many years. We are quite will- ing to receive correction in this respect by any competent observer. Beale has taught that cancer is bioplasm with a diseased impress; that is, the blood element has a taint which manifests itself when it has a chance. It is latent till the conditions of development arise; till then the germs, so to speak, do not exist. This is his explanation of the hereditary taint. In our present status of knowledge, Beale’s view must be accepted till a better is presented. But our point is that, as cancer is not found in the blood, we must look for it in the solid tissues, which are generally found in rank, lawless development; in weak organizations with no powers of resistance like healthy tissue, the histological elements being out of normal place. This being so, then we may look for analogues in other kingdoms where tissue ab- normal changes occur in organisms that can be studied, or have been studied, by man for ages; that is, the vegetable kingdom. If a farmer undertakes to raise potatoes with- out manure, the crop is liable to be stunted, diseased with parasites, tumors and soggy structures, and no one wonders. Other things being equal, the result is by thoughtful minds attributed to want of proper soluble mineral food, and the researches of scientists bear out this popular view; so that it may be said, in general terms, if one wants to produce diseases that are analogous to what we call cancer in the animal kingdom, it is only necessary to inter- fere with this natural condition of growth, of which food is the most important element, as without food the plant could not grow at all. For more ideas in this direction, see the ad- mirable series of volumes by Prof. S. W. John- son, of the Connecticut Agricultural Station, “How Crops Grow,” etc., published by Orange Judd & Co., New York. Reason 2. Cancer is thought to be a. disease of nutrition from the variety and multiplicity of its macroscopical appearances. My father, Dr. Benjamin Cutter, once had a patient, a young man of thirty years of age, who died of an obscure disease, the real nature of which was proved by a post-mortem examination to be cancerous. The writer was the only one who suggested such a diagnosis, from the pres- ence of some hard kernels in one testicle. Being nothing but a medical student, his opinion could not have had much weight. To be brief, the abdominal and thoracic cavities contained over a hundred cancerous tumors and conditions, of several colors and forms. Some of them were in contact with the peri- toneum, red as a lobster, with flattened, cre- nated edges, one and a half to two inches in diameter, free and unattached, like chips care- lessly thrown in. Saddling the lumbar verte- brae was a large liver-like tumor that weighed several pounds. It was in organic connection with the bodies of the vertebrae, which, re- moved and sawn into, disclosed the disease inside of the bones by the black, burnt color of the spongy structure and its diminished trabeculae. The liver had its convex surface nearly all occupied with a large, thin, trans- parent sac filled with a hyaline, blue-colored liquid, whose morphological elements were made up of caudate, mother and hyaline cells resembling cartilage cells in perfection. Over the lungs were found very numerous free and variously colored cancerous growths. Some were found in the lungs and heart. The nodules in the testicle were also cancerous. In short, there was hardly an organ or tissue that was not profoundly invaded by the diseased condition. Though this, to the writer, was an unparal- leled case and the relation is toned down, still it practically exhibits in one instance how cancer may riot with all tissues. The man suffered untold agonies of body, and the general opinion of the physicians present was that this remarkable condition of organic disease was induced by habits of dis- sipation, wrong feeding, and bad modes of life. It is quite certain the professional gentle- men would not deny that cancer in the case was a disease of nutrition, though the family was wealthy and were good livers, so-called. Disease of Mal-nutrition—Cure of Malignant Disease 15 Reason 3. Cancer is regarded as a disease of mal-nutrition because fibroids and solid tumors do cancerously degenerate. One case of the writer was a large, multilocular, sub-peritoneal, abdominal and pelvic fibroid that was carried for thirteen years, the subject maintaining her place as mother of a large family for this length of time. In early spring she moved into a house that had been unoccupied all winter, and stood in a low, marshy place. She took cold, was overworked, and never properly fed, and her disease changed its character. She then went to a hospital, and was nightly subjected to vaginal douches of hot water, which, she said, always scalded and made her worse. At my visit she had returned home, being given up to die, as the disease had involved the body and neck of both bladder and womb and all the fibroids. It is clear that when such growths put on malignancy it must be from some modification of the nutrition, and in the case given may have been somewhat as follows: The patient had had just about vitality enough to carry her fibroids, but when the extra demands on her nutrition were added by the domestic exigencies referred to, then the tissues of the fibroid ran riot into cancer. She attributed the rapid in- crease of the disease to the depressing influences of the hot water. Reason 4. Cancer and other organic disease is more prevalent among those who are ill-fed, improperly fed and abused by themselves or others. For example, the writer has known a case of cancer of the stomach, when it was evi- dently caused by living in the suburbs and having business in the city, taking a light lunch there and returning late in the day, all tired out and having a hearty supper with much condiments. A case of fungous haematoids, involving the left shoulder-joint, and finally attaining a diameter of at least one foot, occurred in the practice of the writer’s father many years ago. It was an awful sight, with its livid volcanic- like protuberances. Indeed, it made up the larger moiety of the boy’s body at his death. Now, this patient was ten or twelve years old, an orphan, obliged to pick up a precarious living by setting up nine pins in a bowling alley. For some real or fancied neglect of duty he was beaten with a nine-pin. He soon after developed the disease, and ran away from the city into the suburbs on a railroad track, being found disabled on the track, and was cared for by the town authorities as a pauper. This terrible case of cancer was made possible by ill-nutrition in poverty and orphanage. Wealth, however, does not necessarily give good diet. It is almost useless to enlarge on the idea that defective alimentation is a predisposing cause of cancer, nor is it worth while to adduce more reasons in favor of the view that the various diseased conditions called cancer are tissue dis- eases of nutrition, though it may not always be possible to trace the connection clearly. The warp and woof of disease embrace many dif- ferent causes, all very much mixed. Indeed, it is so with most everything, even an appar- ently trivial event. So, when the multiplicity of causes, functions, operations, forces, factors, and conditions that combine to produce what we call life in the human system are taken into account, it is not to be wondered that the etiology of disease is a very difficult subject, and all reasoning about it is liable to doubt. Still, as tnere are salient features in landscape scenery by which we identify localities, so in the disease under consideration, mal-nutrition, however caused, is a great predisposing moun- tain or landmark of identification. Malignancy.—The return after removal and the tendency to a fatal issue form the idea of malignancy which the profession and public attach to cancer. And the real issue in the present writing is —can a malignant disease that has shown its character by recurrence be arrested and dissi- pated? Yes; and Dr. Twitchell’s case proves it. But, says my reader, it is only one case. True; but it is positive, and, so far as one case goes, it shows the possibility of a so- called malignant disease being not malignant, and thus we are set face to face with the dic- tionary and our landmarks of knowledge. But are our ideas to be measured by opinions or by facts ? Language is not fact. It is, or should be, an account of facts, which are eternal, while language changes in form, words and spelling, so that in six hundred years one can hardly realize that our language is English. Again, as the world moves on, things that are declared to be impossible by foremost scientific and learned men have become facts almost while they are speaking. A notable instance of this occurred in 1858, when a learned so- ciety in London awarded a gold medal to a 16 Ethics of Impossibilities—Tissue Molecular Changes. savant who read an essay on the absolute im- possibility of laying an Atlantic Ocean tele- graph cable, but the cable was laid before the medal could be put into the hands of the sci- entist, and has been, with others, a great ac- complished fact in our modern civilization for over one-fourth of a century. Wonder if the savant got his gold medal ? It so, I don’t think that he makes much show of it. So, also, of Faraday and his celebrated utterance as to the absolute impossibility of ocean steam navi- gation. These are not adduced to show that all new things are possibilities, but that some are, and people should be cautious not to take positions as to impossibilities unless they are well ac- quainted with the facts in the case. You say that there is but one case like Dr. Twitchell’s, but this is not the same thing as saying that there are none such. The fact is, there is but little encouragement to report such cases as things now are. Few have the courage of a Bowditch to speak out the truth when it must disturb settled con- victions and established opinions. And who is there that knows but that other cases, faithfully carried out like Dr. Twitchell’s, might not have been cured ? As, if one case has been cured, it is possible more may be. (The cases here are very respectfully presented to the consideration of the profession.) Just here is the rub. Few have the energy of char- acter to act up to their convictions and carry out a plan that rides across the usages of society, the appetites and the deranged desires of a sick and diseased body. It is training for health against disease. There is also paralysis and indifference to the fact of a great impending catastrophe, though the condition of mind may be just the opposite. Writes a patient:— “ Cancer is the worst word in the world to me. No one could have failed faster than I did for two weeks after what Dr. M. said to me. . . . You, who are so strong and sensible may think me silly in this, and we will let it go that I am.” It now remains to point out the bearings of food upon cancer. If cancer is a disease of nutrition, why is it not the most sensible way to attack it through the food ? Starting out with the proposition that if any animal gets its normal food and is situated amid circumstances favorable to life, then the animal will be healthy (this is from the same root as hale, whole, holy, holiness); that an individual that is whole, symmetrically developed and acting, the tissues normal, the organs perfect, that individual will be healthy. This is understood by man as applicable to other animals than himself. Hostlers know how to bring up a horse to health by giving him healthy feeding. Dairymen know how to feed their kine; trainers their pugilists, walk- ists, boat-racers, etc. All seek to get the sys- tems of the animals in their charge in splendid condition, and then the diseased condition will leave as the “carpet baggers” did when government was established in the South. This is so important a principle that we restate it: When the human system has its skin, liver, pan- creas, kidneys, and digestive canal all in splen- did order, the vis mediatrix natures of the older writers will set the diseased conditions, of any kind, right. By disease we mean morbid changes of organic structure, though in a broad sense it includes sickness as well. But sickness is rather a functional disorder or derangement than one where organic morbid changes are such as are found in chronic disease. The expression in the Gospel, “He healed all manner of sickness and all manner of dis- ease,” is very explicit. Now, both are sort of physiological mobs. And, if you look at cancer as tissue run riot in a mob, it is to be quelled as mobs politic are by law and order. If the riot is too strong for the law and order, then down goes the law and order. If the cancer riot is too much for the physiological law and order, the body systemic perishes. Suppose one of the organs named is af- fected ; if all the others are in splendid order, they will do the work of the affected organ, on the principle of vicarious function. For ex- ample, the skin will do the work, to a great extent, of the kidneys, etc. Now, the molecular laying down and taking up of all the histological elements of the va- rious organs and tissues of the body systemic are going on all the time. The time, ac- cording to the popular ideas, has been esti- mated to be seven years in which the whole body changes. Dr. Lyonell Playfair has stated his belief that in seven months it is changed. The writer thinks this estimate is much beyond the truth. Be this as it may, seven months is enough for our purpose. Food and Disease. 17 ABNORMAL TISSUES SUBJECT TO NUTRITION. The profession entertains the idea that only the normal tissues are subject, and that the ab- normal tissues are not subject, to this law of molecular nutrition change. This is, to my mind, a great error. Given good blood, good-working digestive, circulating, respirating, and secreting organs, if there is a diseased condition, the tendency is to remove that condition and establish a healthy one in its place. This is seen in practice. FOOD CURAT1VELY CHANGES TISSUE. Admitting this for the nonce, as we should get ahead of our subject if we should prove it now, we would observe that food is “an agent of tremendous power ” in the treatment of diseases not cancerous. For example, in 1862, a man lay sick in Washington with typho-malarial fever, so diag- nosticated by good authority. The disease was contracted in the Army of the Potomac. When the writer found him he was delirious, violent, tearing off all his clothing, trying to jump out of a third-story window, absolutely refusing to take anything in the shape of food or medicine. This state of things had lasted several days. The prognosis by competent medical authority being fatal, the writer was left to watch for the inevitable death. But, somehow the idea of starved nerve-centres was suggested, and with considerable opposition on the part of the household (the effort being looked on as entirely useless), some beef-essence was made by cutting lean beef from the top of the round into cubes of half-inch size3 these were covered in a closed jar, without addition of any water or anything else 3 the jar was set in a pot of cold water and the water brought grad- ually to a boiling-point and kept so for two hours and a half. The juice was then ex- pressed through the meshes of a crash-linen towel. A coffee-cup full of this was obtained at night when men were at hand. Five of them held the patient on the bed by main force, one at each limb, and one at the head held face upward. The writer then forced open the mouth and poured in the essence, and held it there till it was all swallowed. Then he was let go, and, instead of repeating his fierce efforts and movements, he lay quietly down and slept like a child. At the expiration of two hours, more beef-essence was administered with the same effect. This proving satisfac- tory, the plan was kept up until convalescence was established, and in less than fourteen days, the writer took his patient to Massachusetts. He is now living, an active business man of Boston. Some quinine was given after con- valescence, but the cure—and there was a cure —was effected by the beef-essence and nursing. Another case, a daughter of a well-known physician in Middlesex County, Mass., aged io years, had an attack of what he called typhoid fever. He had been a surgeon in the army and navy during the rebellion, and there is no reason for doubting the accuracy of his diagnosis. During convalescence she began to fail rapidly. The parents sought advice of the writer, saying she would eat nothing but beefsteak, and, fearing to give it to her, they were at a great loss to know what to do. “Give her all she will eat,” was the advice. A letter soon came, asking, “How much by weight?” “Anything under four pounds,” was the reply. She ate freely, and in two or or three days was up, dressed, and down stairs, and is alive and well to-day. During the summer of 1877, the writer was in Peabody, Mass., in consultation with a very reputable and worthy physician, in relation to a case of ovarian tumor. After this he said that a middle-aged lady, mother of a family, in whom he, for personal reasons had a deep interest and did not want to lose her, was very low with Bright’s disease, confined to bed, pale as the sheet she lay on, vomiting all food, ema- ciated, too feeble to raise her head from the pillow or lift her hands, urine one-third albu- minous, etc. He said, also, there was to be a consultation immediately with some physicians to act on the dernier ressort of transfusion of blood, which her husband was to donate from his arm. He asked if I would perform the operation, if it was thought advisable. On the consultation, the statements were found to be true, but there was no apparatus to transfuse the blood3 so it was arranged that I should re- turn to Boston and come back with it at 10 a.m., next day. Before I went home I had a solitary interview with the lady. I took my diet-list, and began with the articles named in order, and asked if she could eat them. She answered “No” to each until I named “tripe.” She said she thought she could eat some. “Stop right here,” said 13 “get some of the best tripe to be found, broil it and let 18 Loss of Nerve-Force a Cause. her eat all she can or wishes. In case she vomits it, let her have some more. Give her nothing else.” I went to Boston and returned as agreed. At the station the doctor met me and said : “There will be no need of perform- ing the operation.” I saw his face was smiling, so was quite prepared for the favorable report that she had eaten tripe, kept it all down, and felt so much refreshed that it was needless to go on as proposed. She continued to eat tripe. In March, 1886, in company with my son, I saw this woman. She was apparently well, though not able to do much work. Dr. — in- formed us that the casts and albumen did not disappear from her urine till more than a year had elapsed. Her diet till cured was mainly tripe. 1891, well at last accounts. The writer knows of a case of consumption of both lungs and double pleurisy, in 1862, given up to die by his father, Dr. B. Cutter (a physician who honored his profession for forty years), and by himself. This case, after living during one winter on a fat hog and nothing else, was cured without attendance or medi- cine, and a few years since was sent to the house of correction for being a hard drinker. Died of drunkenness about 1888. A physician’s wife, eleven years ago, had a fibro-cystic tumor that extended from the epigastrium to within one inch of the vulva, the vagina being prolapsed. She went on to a diet of lean beef alone, and in three months the cyst had decreased so as to just protrude above the pubis. At last accounts remained cured. Another case of fibroid, which had existed for fifteen years, under like treatment, com- bined with the iodide of potassium (she was syphilitic), resulted in the complete disappear- ance of the tumor in the course of two months. The late Surgeon F. M. Dearborn, U. S. N., left Boston once in midwinter on board the “Franklin.” They were caught in a snow- storm and he had at once 80 men down with pneumonitis. He fed them beef freely, and 1 case only died, though all were severely sick. These cases have been adduced only to show the power of food in treating other diseases than cancer.* LOSS OF NERVE FORCE A CAUSE. Mental depression is too often an element in cancerous cases to be overlooked. There is nothing like worry to wear on the nutrition of the body. Worried lovers of both sexes, even the1 poets rhyme about their loss of flesh. The worried men of business, and women, who do far more work than most business men (for the writer believes that a mother of a large family has more demands made on her worrying facul- ties than the heads of great mercantile houses), grow poor, though poorness of flesh is not an infallible sign of worry. Now, sudden, marked and decisive loss of flesh from worry shows a terrible strain on nutrition. As we now understand it, the explanation is that it takes so much force to “run” the nerv- ous system, under the exhaustive strain of wor- riment, that there is none left to “run” the tissues, and the waste is not supplied and vital force is not given to the local nerve-centres of nutrition, and it is but a step or two from tissue wasting to the mal-produced tissue of malignant and non-malignant diseases. No doubt had Case XVIII lived on the animal diet exclu- sively she would not have had the mal-nutri- tion, for the following reasons: The animal diet puts the system in splendid condition, and confers strength to bear up under the stress of worry, etc. One way in which this is done is by saving the forces. It is more work to digest vegetable food than animal, and the nerve-force saved is no small item. If this is doubted, study the effects of baked beans on epileptics and bad vegetable food on children or adults. It would seem as if the ganglionic nerve-centres that preside over digestion in such cases were so completely overwhelmed that all the other nerve-centres are involved in the loss of force, and the epileptics and the colics must be re- garded as the result of a job of digestion too great to be done; for, change the patients over to animal food, properly prepared, and the fits and colics cease. Language here seems to fail to be adequate for the ideas to be ex- pressed. This case (XVIII) lived on flour-bread, sugar, tea, coffee, some animal food, probably about one-sixth of the latter to five-sixths of the vegetable food. The flour and sugar being largely in excess and both very poor nerve- foods, is it a wonder that tissue degeneration resulted, as there was a tissue taint ? This great element of depression aids much ♦Cutter, E., M.D.: “Feeding Patients Against the Appe- tite,’’ Medical Register, Philadelphia, April 2 and 9, 1887 ; “Seventy Cases of Consumption,” Trans. Amer. Med. Assoc., j88o, pp. 338-408; " Food as a Medicine in Uterine Fibroids,” Amer. Journ. of Obs., October, 1877 ; “ Food as a Medicine in Agalaxia,” ibid., April, 1878 ; “ Food as a Pathologic, /Esthetic, Chemic, and Physiologic,” Amer. Journ. Den. Scien., Balt., January and February, 1880. Best Conditions for Cure. 19 in the tissue riot. In patients hope must be inspired, faith must be raised, and not only must the physician believe, but he must make the patient believe. Everything must be hus- banded. There must be no force expended on anything else but running the system and fight- ing the disease. THERE ARE DIFFERENT TYPES OF DISEASE. Cancer has them, too. Some types are quick and kill almost by a blow, or destroy like a hurricane or earthquake, against which man is powerless. These admit of nothing like possibility of cure. There is not time left to save. Like a stroke of lightning, it kills resistlessly. But when the disease is slow, the circumstances favorable (and this means a great deal), and all work together with rigid fidelity, why, there is a possibility of doing good work. BEST CONDITIONS FOR CURE. The best circumstances are a sanitarium de- voted to this purpose, where systematic treat- ment can be practiced, the food selected care- fully, the cooking perfect, and the patients not allowed to vary from the plans. Oftentimes they begin, run well, and seem to realize the situation, and the growth shows a diminution, and then they will fall away from the diet, and often charge all the results of their backsliding to the plans of treatment. It is a great thing to manage patients and keep them under con- trol. All will allow this, for, if not, no good results can be expected to follow. Every means should be used, then, to keep up the discipline. Frequent communica- tions, examinations of the blood, urine, and faeces to see if there has been any variation, and, when detected, to stimulate the poor, weak offender to the narrow, straight path of duty again. Lapses must not go unnoticed. The patient must be watched with jealous, in- terested care. Then, if time enough is taken, comes the possibility of cure. But all the chances can be lost very easily. A few mouth- fuls of wrong food will do essential damage. “ Few appreciate how sensitive the system is to daily and hourly impressions.” A weak, irresolute mind, wavering character, restless and peevish disposition, a constant view of the dark side—these qualities will not succeed in hardly any work. One who gets well by self- denial, faith, perseverance, pluck, determina- tion, energy, is like the victor on the battle- field after a long and tough fight. There is the same exhilarating triumph, and after the con- flict is over he finds a conversion of appetite. Food liked before becomes distasteful, and it is very easy to go on in the right mode of living, so that, the predisposing cause being removed, the disease is vanquished by the simple molecular changes of nutrition. Nature does the work. Medicines are valuable to stimulate the glands, remove engorgements, and keep all the organs in good working con- dition. This is their place, for medicines do not cure of themselves. When a ship’s cargo is shifted so that her spars dip into the sea, it is re-arranged by the crew, and the ship rights itself, and the crew say, “ We have righted the ship.” This is certainly so, but nature had a great share in the work. The crew simply acted in obedience to the laws of gravitation. So man cures disease. The medicines, food, etc., help nature, and, in accordance with her laws, she does the cure. IT TAKES TIME. Agree to have a possibility of cure of cancer, there must be time—one to four years. This is a barrier to many. They could go one to three months, but not a year, and so throw away their chances. IT TAKES MEANS. Unfortunately, the terrible disease comes to the poor and ignorant, and there is no help for the words of the preacher, “The destruc- tion of the poor is their poverty.” It is a costly matter to provide for the sick of this class with food, care, nursing, and medical attendance. The medical profession give away an immense amount of unrequited services, but so long as they are not supported by the public, they often give away more than they can afford to and impoverish themselves. Here is a chance for the benevolence of the rich if it could be rightly adjusted. Many lives are now being saved by the bounty of the rich, but many are being lost for the want of aid. It would be possible to save more cases than now, were more means at command. PUBLISHED CLAIMS TO CURE CANCER. The papers are full of such claims, and, in the present state of the medical profession, it is difficult to see how any estimate of them, other than bad, can be made, simply from the fact that it is very dangerous for any medical person in good and regular standing to have anything to do with what is called * ‘ quackery. ” 20 Published Claims to Cure Cancer. Still, the people patronize them, and reports of cures are rife. Now, it is possible that some of these cases may be cancer, and may have been cured by quacks. History shows that Lazarus Riverius was a quack, yet he did much to advance medicine. Not long ago one of the most eminent surgeons was extolled by a lay- man for his wonderful operations on the blad- der; yet a swineherd in France is said to have introduced the operation for stone, and must have been a “quack.” A good many surgeons have founded their great reputations on some operation of centuries ago. The cancer hospitals in New York, in their public utterances, claim to cure at least one- third of their cases. It would be interesting to know what they call cures. Generally, cases operated on for cancer die in two years, but some of the diet cases of cancer have been cured for more than ten years. There is said, on good authority, to be in a town in central New York a family who treat cancers by the use of a paste, the formula of which is known only to two members. They have made immense fortunes, have large estab- lishments, and effect many cures (?). Not long ago a distinguished politician of Boston had cancer of the leg, and went to this place for treatment. It was a bad case, and seemed unfit for any treatment, and was dismissed. This action was creditable, as there was plenty of money in the case. Evidently something is to be learned here. If we had patronage in this country, as in the old, such a patron could organize a commis- sion of medical men, and have it authorized to make an investigation by some organized body, as the American Medical Association, and pay the expenses. The report of such a commis- sion would settle the matter for the profession. Should it be found that it is a fraud, the patron and profession would gain credit for using all honorable and legitimate means to avail them- selves of the knowledge. Should it be found that there were cures, then due credit should be awarded as deserved. In passing, as to these pastes. The writer, a few years ago, had a case of epithelioma of the tongue, in Connecticut. The tumor was about i y?, inches long and i inch wide. The case was put on diet, with the understanding that if there was no improvement the tumor was to be removed by the galvano-cautery. Officious relatives and friends took charge of the case, and the patient was sent to North Adams and operated on by paste. He suffered indescribable agonies, “ the torments of hell,” as he told my son afterward, and caught cold by staying in an unwarmed room, and died at his home soon after his return. I saw him a short time before his death, and found that the cancer- tissue was destroyed. I have since been in- formed by my son that while attending the clinic of one of our most eminent surgeons he heard of a case of epithelioma almost similar to this one, which was removed eight years ago by the galvano-cautery, the patient now being in good health. These North Adams cancer people sent down a young man to doctor General Grant, and I deemed it my duty to write to one of the General’s physicians, informing him of the facts above stated. My letter was given to a Boston Herald reporter, and published in that journal; so I trust that his posing as a martyr of bigoted doctors was somewhat offset. What makes the writer think that some cases may be cured as represented is that he once saw a case that twelve years previous had been under the care of a so-called famous cancer doctor in Boston. The woman said she had been as she was when seen by writer—bloody vaginal discharges, agonizing pain, walls of vagina and urethra like stone, terribly hyper- sesthetic, etc. She died thus, and the writer could not but look on her as a case of cancer. However, more lately the writer saw another case of this same doctor, called cancer, and treated by him for years as such, but which, when examined, proved to be a fistula in ana of fifteen years’ standing in a remarkably healthy woman. A papilla, large as a fore- finger’s end, occupied the perineal end of the fistula, and the ordinary surgical operation with one cut did away with the “cancer.” They make more thorough work of these things in Paris. A few years ago a mulatto gained a tremendous celebrity as a cancer doctor, and was surrounded with an abundance of wealthy and fashionable clients, and made fame and fortune. But when he was given wards in a hospital, and cases were carefully watched, his star went down like a descending rocket, as his claims were not sustained. It may be his treatment was thwarted unfairly. We hope not, as it is a terrible subject to trifle with. Every advantage should have been given Other Considerations as to Food. 21 the claimant, as there doubtless was, even if irregular and ignorant.* But, a regular or irregular medical man, who has, or thinks he has, anything to throw light on the possibilities of curing cancer, so long as he observes the rules of good society, is entitled to a respectful hearing. It is too bad that original workers are bulldozed, in- sulted, ridiculed, and put down by men who profess to be gentlemen, scholars, physicians. This is bad for the workers, who are thus soured and discouraged. It is bad for the pro- fession, as it often loses the knowledge it needs to save life and prevent misery. It is, to speak plainly, a devilish thing thus to throttle prog- ress, and is worthy of the dark ages of ignor- ance and superstition. It was enough to raise a storm of righteous indignation to see how some tried to hoot down Dr. Sayre and his plaster jackets. To interfere with any means whereby the miseries of poor humpbacks could be relieved was a hellish thing. OTHER CONSIDERATIONS AS TO FOOD. To syllogize, some difficult cases of chronic and acute diseases of nutrition have been cured by food. Cancer is a disease of nutrition. Hence, it is not improbable that cancer may be cured by food. Or, food has proved to be an agent of tre- mendous power of cure in some acute and chronic organic diseases. Hence, cancer may possibly be cured by the tremendous power of a food. A comprehensive view of food divides it into animal, vegetable, and mineral. It is any sub- stance taken into the system to sustain life in all its varied phases. It includes the air we breathe, the liquids we drink, and the aliments we eat. Air and water are mineral. Animal and vegetable food are organisms with which we all are familiar. The human animal, to exist in normal con- dition, must continuously and constantly come in contact with foods derived from the above sources. The range of alimentary objects for man is very large, yet we find him about as helpless, feeble, and weak in his choosing as other animals, though he must select his normal food, as they do. But, curiously enough, in his early history, nature provides a bountiful supply for all his wants, if she is let alone, in the shape of that unique and wonderful product of the protoplasm of the epithelial cells of the mammary glands— milk. Whatever difference of opinion there may be among intelligent persons as to the diet of after life, there is none about the first supply. It is animal food. Under its use, provided the mother is healthy and properly fed, the infant thrives and is one of the most beautiful objects found on the earth. The urine is free from odor, clear as champagne, no deposit on cool- ing, 1015 to 1020 specific gravity, the faecal evacuations are not disagreeable to the smell, and when examined are found to be structure- less and homogeneous under the microscope. Milk contains all the elements of a perfect food. Were it not so common, the world would marvel at its wonderful properties. But it should be taken direct from the glands, in order to prevent the fermentative vegetations which so soon develop after it has been re- moved. The processes of nutrition in a healthy babe are certainly up to the standard of perfection, and one would hardly expect to find the disease we call cancer in them. It is possible that here is the key to Dr. Twitchell’s case; in the milk consumed he found a natural aliment by which he put his system into such perfect order that the diseased condition near the eye was removed, as it were, by the natural laws of the body. But, to our subject. When the infant has become a child having teeth, the period of weaning is over and the child enters on a new regime of existence, cutoff from its magnificent food of infancy, and the all-important subject of what to eat now has to be settled at once. On what grounds is it usually settled? On those of ethics, manners, and customs; always more or less, where possible, on the ground of aesthetics, or the love of the beautiful in relation to appetite or the sense of taste. The writer is aware that the cultivated con- fine aesthetics to the senses of sight and sound— architecture, painting, music, oratory, etc. But these are all forms of motion; that is, in the actual realization of aesthetics. Still, take a hungry man after a long day’s work, the appe- tizing food will appear more beautiful to him by as much as it is more necessary than all the delights of the eye and ear. The history of he aesthetics includes the delights of the cook as * Perhaps this doctor conferred force or virtue or dynamos as the Greek has it, which gave nature power to heal, for she will heal anything if she has a chance. 22 Other Considerations as to Food. much as those of the artist. Indeed, some cooks call themselves artists, and rightly. But, this as it may, it is an undeniable fact that man selects food because it is pleasant to the eye, taste, touch, smell, and hearing, and not wholly for the purpose of sustaining life and satisfying the wants of nature. So it will be seen that our common diet-lists are made as much to correspond with the de- mand of aesthetics as is possible with the mone- tary means of the parties concerned. Parents and guardians select this food. Those things which are pleasant (aesthetic) to the taste are much in demand—sugar and its prep- arations, for example. It is eaten not for the dietetic value, but because it tickles the palate with its delights (gustatory aesthetics). This article is consumed in enormous quantities. So fruits are judged by the senses of sight, touch, smell, and taste. When we were boys, did not cherries appear more tempting to the eye than they were pleasant to the taste ? This subject is worthy of development in a book. Other aspects of food are hardly consulted by the great body of eaters. These are the chemical, physiological, pathological, and therapeutical. There has been, and probably ever will be, the greatest diversity of opinion as to what con- stitutes the naturalfood of man, far more than for the so-called lower animals. What to eat has been the watchword of nations, religions, and governments for ages. Some say no animal food should be eaten, and others say the reverse. Vegetarians fight animal- foqd eaters, and vice versa ; but, so,,far as the can judge, it would seem as if the ques- tion had settled down to the proper proportion of animal food to vegetable food. This is not a polemic paper; hence, we would respect those who respect 11s, and, while we would not try to force our convictions on others, at the same time we would maintain our own views and give the reasons therefor, as, if they serve no other purpose, they can act as a history of opinion prevailing at the present time. The writer adopts the plan of two-thirds ani- mal and one-third vegetable as the natural, normal food for man in health after weaning. The reasons are:— 1. When men desire to accomplish certain feats, like a contest of pugilists or of boat- racing, they go on to this plan nearly, with ex- ercise, and the invariable result is a wonderful improvement in physique, and the more rigid the training the better the chances of winning in the competitive contests. 2. Such a diet has been found, in my own experience and that of others, to supply the nursing mother with an abundance of milk for her offspring, of a healthy kind, so that the babes have thrived wonderfully, and the supply has held out longer than when the mother was fed on other food. 3. The urine of those who live on this pro- portion of animal and vegetable food is almost identical in physical characteristics with that of the healthy babe. The usual offensive odor of urine does not belong to an absolutely per- fect state of health, and many persons go through life calling themselves and being called healthy when they are not. The human body is very accommodating to circumstances, and elastic. It will exist under unfavorable circumstances, and there must be great allowance made for constitution, charac- ter, etc. But healthy feeding, other things being equal, will give great advantages over un- healthy. Some of these circumstances are occupation, bathing, exercise, cleanliness, healthy telluric and atmospheric surroundings, wars, rumors of wars, pestilences, perils by land or sea, governmental conditions, color, sex, profession, education, race, industrial and geographical environments, etc., etc. 4. The fact that about two-thirds of the fifty- two teeth of the human being are mechanically formed for eating meat, and about one-third are formed for vegetable, is also another reason for this rule. 5. Again, the stomach is organized to digest meat, while the small intestines are provided with glands to digest vegetable tissues. For this reason the diet should be mixed ; that is, animal and vegetable, and not exclusion of one or the other. 6. When an adult lives on this proportion, one finds the same physical qualities of the urine and faeces as found in healthy nursing infants, and if intestinal gases are voided they do not have the rank sulphuretted hydrogen odor so common to discharged intestinal flatus. By this it is seen that this standard of health is set high, too high, perhaps, as it is not often found; but still the fact remains that this re- sult may be obtained in almost any case of dis- Fibroid Tumors. 23 ease, no matter how chronic or severe, if the patient will live faithfully to the plan which is more rigid than two-thirds animal and one- third vegetable, as to the writer’s knowledge has been done and is being done in consump- tion and syphilis, to speak of no more. These tests show to the writer’s mind the validity of the position taken, in a practical way, by actual examples of living cases watched by chemi- cals and the microscope so positively that he does not propose to give up until the opponents of the position demonstrate that it is incorrect, not by simple dicta, but by the tests of physical explorations with the best modern instruments of precision. The kinship of uterine fibroids, according to the present view, is close enough to allow the introduction of the principles of treatment in this place as presented to the Tenth Inter- national Medical Congress, at Berlin. I. “ Our bodies change once in seven years.” I think, with Dr. Playfair, of London, they change once in seven months, and oftener. II. The body is all the time being laid down and all the time taken up. Healthy or unhealthy tissue alike. III. If there is force enough for the body systemic the tissue will be laid down and taken up normally. IV. If there is not force enough to do III, then abnormal action comes, and the result may be chronic disease. V. The way to remedy the trouble is to re- store the normal power of the body systemic. 1. By proper feeding. 2. By proper hygiene. 3. By proper medicines to tone the glands, aid the digestion and elimination, and make the machine run smoothly. 4. By saving the useless expenditure of nerve-force in (a) work and (b) too much pleasure. 5. By the conference of nerve-force by mass- age, horseback-riding, and in fresh air. 6. By the inspiration of hope; thus psycho- logical force is given and the sympathetic nerves have a chance to do their work. 7. By galvanism. This cannot be ignored. How it acts, I do not know. It may be, as with throat topical applications, we stir up things in the hope that as they settle down they may settle healthfully. At any rate, galvan- ism, given by profound puncture into the sub- stance of the tumor, strongly stimulates the vasomotor system. We have much to learn in this direction. 8. It should never be forgotten that nature is always willing to cure if she has the means to do it with. That some of the conditions we call disease are merely manifestations, or the results of the manifestations, of nature’s efforts to warn off or expel or relieve unnatural action. 9. When a case is cured, we can only say that in some known or unknown way we have aided nature, and she has cured, not we. 10. So long as we can trace at least three- fourths of all our diseases to improper feeding and wrong modes of life, it follows that food in fibroids is the most important thing to be looked to. If you give normal food, other things being equal, and, as the Irishman says, “your patient lives long enough” (that is, not upset by intercalating causes), nature will cure numbers of cases now not cured, simply be- cause she has power enough to enforce her own laws. is afo institution inhere aases of carrcer andNuirfor plans. E. Cutter. “ The 7§w »WbADWAY. New York. Heartrest Sanatory, MOTT AVENUE AND 165th STFEET, NEW YDRK. Address communications to Dr. fohn A. iuiter, Busines s Manager, CP** iT ■1 TWA CIR :ULARS OF INFOl LMATION. No. 1. General circular of inf on, rntion. No. 2. Consuvption of the Lungs No. 3. Diet in Tumor and Cancel. No. 4. Bright's Disease, Impending Apoplexy, Paralysis, Cata ract, and Fatty H ’art. No. 5* Asthmc, Hay Fever, Bronchitis, and La Grippe. No. 6. Heart Diseases and Rheumatism. No. 7. Disease.' of Women. \ The aim is to he il those cases of chronic disease commonly called incurable. The Sanatory is located on high ground, in a square plot bounded on three sides as above and by Sheridan Avenue, commanding a fine view The drainage is new ; buildings are spacious and surroundings good. It is approach ?d by the West Side Elevated Roads to 155th Street, ther ce by carriagt ; from Gram Central Depot by Harlem Railroad to Mott Haven Station, thence by carriage; and irom Melrose S ;ation, on the f ame rail- road, ten minutes’ walk. The results that we have ac aieved in our work in Heartrest Sanatory show the greater value o an insti- tution of its kind than the meais afforded in handling cases in private practice. All rij hts reserved. Copyright, 1891.