Part 7

Though this _Problem_ at first View may seem to be too near allied to that which proves the Impossibility of curing cancerous Tumours, whether ulcerated or not, by Salivation; yet in regard there are some Persons, that tell us the Disease is superable by some internal Remedies, which operate after a quite different Manner, to those generally given to procure a Salivation, we shall enquire into one of the most considerable of them, related by a Person whose Memory we have a very great Value for. And we shall the rather take Notice of this particular Remedy, because we have elsewhere spoke of the Success of it. It were no very difficult Matter for me to mention several internal Medicines, out of our Chirurgical Writers, more especially those that have been Favourers of Chemistry; but I shall purposely decline it, because to speak freely, I suspect that most of the Remedies, though much has been said in the Praise, have not been sufficiently examined by those that recommended them. To this we may add, that had the Authors of them considered the vast Difference there is to be observed in Cancers, they would not have so suddainly and positively determined, that their Medicines were of use in these Cases in general; seeing we must have regard to absolutely different Intentions, in those that are not ulcerated, and those that are, and those that are a hard Tumour, and those that are flat, and likewise when they are conjoined with Circumstances, which are often enough to be met with. The Honourable Mr _Boyle_ in his _Usefulness of experimental Philosophy_, tells us, that he was informed by credible Persons, of a certain _English_ Woman above sixty Years of Age, who had lain long indisposed with a Cancer in her Breast, in an Hospital in _Zeeland_, and was by Doctor _Harberfeld_, with one single inward Remedy perfectly cured in three Weeks; the Relation was made by a _Doctor of Physick_, who was an Eye Witness of the Cure, and another Person who not only saw the Cure, but knew the Woman before, and out of Charity, carried her to him that healed her. Our Author was informed, that the _Chemical Liquor_ the Doctor constantly made use of, does in the Dose of about a Spoonful or two, work suddainly and nimbly enough by Vomit, but hath very quickly ended it’s Operation, so that within an Hour, or less, after the Patient has taken it, he is commonly well again, and very hungry. He adds, that having some of the Liquor presented him, he found the Taste to be offensive enough, and not unlike that of _Vitriol_, which by the Taste and emetick Operation, was guessed to be it’s principal Ingredient. The Relators assured our Author they had been in _England_, as well as elsewhere partly Eye Witnesses, and partly Performers of wonderful Cures by the help of it alone, under God, in the _King’s Evil_; insomuch, that an eminent Gentleman of this Nation, hath been cured by it, when _that Distemper_ had brought his Arm to such a pass, that the Surgeons had appointed a time to cut it off. Now, who is there, that upon reading this Account would not think the Doctor a very happy Man, that was Master of so valuable a Secret; but alas! How satisfactory would it be to the World if the hundredth part of the Remedies that have been handed down to us, had a Power of effecting those things that are ascribed to them, without being attended with any ill Consequences. I assure you, Reader, I have made use of this very Remedy, for since I mentioned it as the Doctor’s having great Success from it; I met with the true Preparation of it, as it was communicated to Sir _Kenelm Digby_ by Doctor _Havervelt_, or _Haberfield_, for the Cure of _Cancers_, the _King’s Evil_, and old _Ulcers_. It is as follows. ℞ _Dantzick Vitriol, calcine it till it be yellow, then grind it with Salt, or Salt Petre, the ordinary proportion with this Sublime Mercury, which Sublime once again by it self, then take only the Cristaline part of it; of this take_ ℥i, _grind it to a Subtile Powder in a Glass Mortar with a Glass Pestle._ Put this into a Glass Bottle, and pour upon it a Quart of Fountain Water, stop the Bottle close, and let it stand thus for some Days, shaking it often; after it is well settled pour off the clear, and filtre it; take a Spoonful of this Liquor, which put into a Vial, and put to it two Spoonfuls of fair Water; shake the Vial well, and let the Patient Drink it in the Morning Fasting: As to the quickness of its Operation, and the making the Patient Hungry, I found it at first to agree with what Mr _Boyle_ says of it; but upon giving it three or four times, the Patient would afterward complain of a Languidness, which was ushered in by a Sickness at the Stomach; after this, they would be attended with a Heat or Soreness of the Throat, immoderate Thirst, convulsive Motions of the Stomach, _&c._ Some of which Inconveniencies would continue for many Hours together. It was upon Account of the Melancholy Reflections of bringing the Patients into such Disorder, and their Unwillingness to endure such Fatigues, that I had never Courage enough to proceed in this Method. I cannot but say, upon the Alteration I found in a Patient of mine, from the use of six Doses of this Medicine, that it may as well as some other churlish Remedies, cure some flat ulcerated Cancers, where there is no Tumour to dissolve, in Persons that are capable of often repeating it, which I think is sufficient to put us upon farther Enquiries, that we may be able to accomplish such Undertakings without bringing upon the Patient such a Train of mischievous Accidents.

_POSTSCRIPT._

What follows is taken from a Manuscript which at this time 1714–15, belongs to one of the Family of the _Pains_, that have for a long time pretended to cure Cancers: In the Margin is this Note, (_Used by my Father, and Grandfather, and Brothers, and known as a thing excellent by long Practice in our Family of the_ Pains:) The Book was lent me by my Brother _Dobyns_, who had it from one of the Family, a Patient of his.

_The Red Caustick._

To eat all Superfluous Cancerous and Schirrous Matters gathered hard in the Edges or Sides of any Ulcer or Cancer, breeding upon the Mouth, Face, Nose or Valva. Take of Bole Armoniac one Ounce, of yellow Arsnic three Ounces, powder them and searse them fine, pare an Apple or two and take of the Pulp and put so much of it to the Powder (beating of it together in a Mortar) as will make it of the stiffness of Dough, then make it up into round Balls of the bigness of a Walnut, dry them in a Chamber-Window till they be hard enough. When you use these Balls shave a little off from them into your Hand, and moisten the same with a little Spittle, and rub it well about the hard Foot of the _Noli me Tangere_, and all over the Head of the same, and after that you have gathered him up into the Ligature and knit him hard up (for it seems they used a Ligature smeared with the Medicine) then apply your Preparation before-mentioned, and lay fine Holland Raggs dipt in the following Red Water, all over the said Caustic, and so let it lye till it fall off its self. _Note_, The Quantity of Caustic laid on, ought not to be much, and yet sufficient to work its effect. It worketh with great Pain for twelve Hours or more, and after that by Fits, like the Tooth-Ach; as the Pain worketh off it causes great Inflammation and Swelling about those Parts it is applied to, but this does not continue above four or five Days; so meddle not with it till the Caustick comes off. Then you may for three or four Days dress the Inflammation with Diachylon Plaister, or the Red Water warm.

_The Red Water for a Cancer._

Quench unslacked Lime in boiling Water, which let stand six Hours, the clear Water poured off, put to the Fire again; to a Gallon and half of which, put _Camphir_ ℥ß _Aloes Succatrine_ ℥ß. _Common Bole_ ℥ii _White Copperas or Allum_ ℥ii all powdered, which boil in the Liquor a little while: He sometimes gave a Pill made of Deflograted Red Precipitate, which sometimes made them spit a little.

_The Musilage Plaister to dissolve Schirrous Knots in the Breast._

Take of the white and inward Bark of the Witch-Hasel half a Handful, cut it short and stamp it, then take of the Roots of Marsh Mallows, Holy-hock Roots two or three Roots, clean them and throw away the Pith, stamp all together, then take of Fenugreek and Linseed of each two Ounces powdered, put all in an Earthen-pot, then take a Pint of white Wine or Water, heat it scalding hot, put it to the Things aforesaid, cover it close, stirring it every Day for nine Days, then strain out the Musilage Liquor with which you make the following Plaister. Take a Pint of Salad Oyl, Cerus finely powdered 8 Ounces, boil them together, constantly stirring them, a sufficient time, which you may know by its coming clear off a Pewter Dish when dropt on, let it cool a little and put in your Musilage, which stir till it be as white as you would have it, and until almost all the Musilage be boiled away, then remove it from the Fire and put to it four Ounces of _yellow Wax_, probably _Galbanum_ may be better, which when dissolved and the Plaister cold, work up for use. This Plaister is sometimes used with equal Parts of _Galbanum_.

THE

CASE

OF

Dr _JAMES KEIL_,

Represented by

_JOHN RUSHWORTH_.

I Should not have been induced to make these Papers publick, barely on account of the rash Censures, that are frequently cast upon the Practice of _Surgery_, not attended with Success; tho’ that Consideration alone, in the Case of a Person of such Value and Eminency in _Physick_, as Dr KEIL is known to have been, may be thought sufficient to have moved me to it: But being certainly informed, That several _Physicians_ and _Surgeons_ have before, and since his Death, given themselves the Liberty to reflect, not only upon me for Using, but also upon the Deceased for submitting to the Methods that were taken with him; I think I shall not discharge my Duty, either to my Friend, or to my Self, or indeed to the Profession, if I do not, as far as I am able, endeavour to set what was done in a True Light.

In order thereunto, it may be requisite to look back to the Time He first mentioned any Disorder in his Mouth to me, which was in _August_ 1716. He then told me, He had preceived a Fulness in his Mouth for very many Years; but in the last Three or Four Years it was much encreased, and by the Bulk began to be troublesome to him, tho’ not in the least painful: Upon examining it, I found the Tumour not only large, but also to fluctuate, and therefore told him, until I was satisfied what was contained in it, I could not come to a Resolution, as to the manner of treating it; but, if he pleased, I would make an Incision into it, and then would tell him what I thought was fit to be done; He was very well satisfied, and resolved I should proceed accordingly.

Upon Opening it, there appeared to be nothing contained in it, but Blood; not in the least altered in Colour, Consistence, or Smell, from what is contained in the Vessels. The Tumour presently sunk very much, and I dilated the Incision with my Probe-Scissers, and pressed in some _Dossels_; and then told him, it was a fleshy Tumour, called a _Sarcoma_, and that the Blood contained in it was only accidental; and that the best way of extirpating it was by the actual _Cautery_; but I let him know, that I feared it would be more troublesome to him, and take longer Time to cure, than he seemed to expect.

We presently sent for the best _Instrument-Maker_ the Country afforded, and gave him Directions: But that Night: talking with him of his Case, I desired him to consider, Whether it might not be thought a Slight, by the Learned of both Professions, if I should Perform the Operation, upon a Man of his Character, without a Consultation; there being no Reason (but the Loss of his Time) to be in haste. At first he seemed unwilling to lose so much Time, yet upon Consideration, he resolved for _London_ the next Day, where several _Physicians_ and _Surgeons_ were consulted; they all agreed, it was a simple _Sarcoma_, and that the actual _Cautery_ was the properest, if not the only means of curing it. This Account I received from the Doctor by Letter; as also, that the _Surgeons_, upon probing, found the Bone bare, and from the ill Smell concluded it was foul: “Which, said the Doctor it was impossible for you to discover; because after I left _Northampton_, Two _Dossels_ of the first Dressing dropt out.” I was very glad to hear That, for those _Dossels_ lodging so long, in that warm Part, I was in hopes might be the Occasion of the fœtid Smell; which the _Surgeons_, not being acquainted with, might fairly be induced to take for that of a foul Bone: Which I mentioned to the Doctor by the first return of the Post; and also, that I was farther encouraged in that Hope, by considering that the Blood, that was discharged at the first Opening, was not at all altered, neither was any Smell perceived, until after the lodging of those _Dossels_.

Whether the Doctor ever mentioned this my Opinion, to the _Surgeons_ in Town, I know not; but when he returned to me, to have the Operation performed, he seemed discouraged by the Opinion the _Surgeons_ gave of the Bones being foul. But I thought I might make bold to confirm him, in my former Opinion, the ill Smell ceasing without the Assistance of Medicines. The Consequence proved the Assertion: For when, by several Applications of the _Cauteries_, I had removed the whole Tumor, it was plain to me, the Bone was not affected; and the Part healed as smooth, and with as much Ease, and in as short a Time, as ever I met any thing of that Nature, and the Doctor continued well, without the least Disorder or Complaint, a Year and about Eight Months.

But then in _April_ 1718. He shewed me a small _Ulcer_, near that Part of the Mouth that was before affected, and told me, He perceived it began upon eating some hot Meat, that stuck to it: At first this healed without much Trouble, but soon excoriated again; and then I could not again perfectly skin it: For as soon as it was almost healed, it would begin to excoriate a-fresh at the Edges, which is what is usual in _Phagedænical Ulcers_. And tho’ I could digest it, and keep it easy, yet it got ground of me, and spread towards the Teeth; and, near the Root of One of the _Molares_, laid the Bone bare, which appeared to me at the first not to be injured, but being long exposed became foul. It not exfoliating in due Time, with the Tincture that is commonly used, I proposed the touching of it with a small _Cautery_, I being able very easily to come at it without making use of a _Cannula_; which, by confining the Heat, very much injures the neighbouring Parts: The good Effect of which Practice, of not making use of a _Cannula_, where you can conveniently omit it, I had good Experience of in Doctor _KEIL_’s former Case: For tho’ he had several _Cannulas_ made in _London_, by the best Hand, yet after Twice using of them, I told the Doctor, That if a Patient could be trusted, it would be much more easy to him, and the Surgeon would see much better to use the _Cautery_, than when obstructed by a _Cannula_. The Doctor was pleased with the Thought, and pressed me, at the next making use of the _Cautery_, to do it without the _Cannula_: The Advantage he had by it was, that it bore four Burnings, and said, It gave him not the Pain, or Trouble he had from but One before, and that the Parts were much less Disordered by it afterwards. But to return:

It will not I suppose be doubted, but that proper internal Means were all along made use of: But the _Ulcer_ still appearing to me more threatening, his Friends pressed him, and I more than any, that he would go again to Town, and have the best Advice it could afford; and I resolved to accompany Him, in the Beginning of _August_ 1718. And I cannot forbear saying I was surprized, when, upon a Consultation, my Brothers, _Palmer_ and _Brown_, made light of it; and, without so much as hearing what I had to say, concluded, That it was chiefly owing to the Bones being foul; and that by drawing a Tooth or Two which they said were affected, and by Purging with _Mercurius dulcis_, all would be well; and so they took their Leave. Says the Doctor to me, “What say you to this?” I answered him, That I feared they would find themselves again mistaken as to the _Surgery_ Part; and that as to the _Mercury_, though a good Medicine, He knew he had taken it already several Times, without any considerable Advantage. The Doctor smiled and said, “But since I came so far for Advice, I will not only give them a Tooth, but also try again what Effect _Mercury_ may have.”

Another Meeting was ordered, and the Tooth-Drawer to be there: Upon Drawing the Tooth, it appeared to be very sound. The First Dose he took of _Mercury_, whether by Cold, or any other Accident, I know not, very much disordered him. I could not conveniently be absent any longer, and therefore the next Day returned into the Country, and do not know how many more Doses the Doctor then took; but in a few Days I received a Letter from him, in which he said, “I know nothing that has succeeded right with me, since I came here: You know what State you left me in, and I was a great deal worse for some Days afterwards; though I hope the _Mercury_ has had no ill Effect, yet I should have been loath to have been so swelled in those Parts, as I have been, willingly. The old _Ulcers_ are not yet healed, they tell me indeed, there is no Appearance of any new Ones, and that the _most effectual_ Methods, which have been taken here, will _infallibly_ prevent every thing, _&c_.”

But by his next, which I soon received, I had the melancholy News from him, That the _Ulcer_ was broke out again larger than ever, and therefore that he would be down with me in a Day or two, and he came accordingly, but in a worse State than ever before. And though it again digested, and did as before near heal, yet the returns were quicker, and upon every new Eruption it was larger and worse; and so continued to be, notwithstanding all the good internal Methods continually used by the concurring Advice of Dr _Mead_, Dr _Friend_, and several other Eminent _Physicians_; which no doubt was owing to the malignant Nature of it.

And therefore in the Beginning of _February_ last, I could no longer forbear expressing my Fears to the Doctor that it would terminate in a raging _Cancer_. He was too sensible of it, and told me, “That since I thought I could keep it within Bounds no longer, He was resolved to try what a _Salivation_ would do:” And though I could say nothing as to the Advantage he might expect from it, yet I frankly owned to him, that if it was my own Case, I should be of his Opinion, that I might make bolder with my self, than with any other Patient: But desired by all means, he would first hear if his Friends, the _Physicians_ and _Surgeons_ in _London_, had yet any other Method to propose, or else would approve of that. He wrote to them, the Answer was long in coming, which made the Doctor express himself to me with more Warmth, than I ever knew him to do before: (For he was a Man of the greatest Command of himself, as well as of the sweetest Temper) “What, says he, is not their Silence enough? And will not you, whom I take for my Friend (for fear of losing your Reputation) assist me in what I desire?” With a great deal more to assure me of his Confidence in me, and of his Opinion of my Ability to take Care of him in the Course. I am not so vain, as to mention all his kind Expressions, yet if it be desired, by any of his Friends, I will give them the Satisfaction of seeing the Letters I had from him, when he was absent from me in _London_.

At this Time his Brother, Doctor _John Keil_, came to him from _Oxford_; and, as I understood afterwards, had seen Dr _Friend_ there, who was for having him salivated at _London_: But the Doctor being determined to the contrary, did not at that Time acquaint me with it, but began his Course, which I desired might be in the mildest Method, by small Doses of _Calomel_, encreased gradually, which Method pleased him very well: But Dr _Friend_ (to whom Dr _John Keil_ constantly sent an Account of our Proceedings) gave it as the Opinion of Mr _Palmer_ and Mr _Brown_, that it should be done by _Unction_: I gave my Reason to the Patient against it, but they still pressed it, notwithstanding the ill Symptoms, that I thought, at that Time, forbad it; which Symptoms they had been acquainted with. They still persisting, I desired the Doctor would give me leave to write my Opinion my self to Mr _Brown_, which I did hastily in the following manner.

Good Brother,

_I Have seen Dr_ Friend’s _Letter to Dr_ Keil; _and Dr_ Friend _I understand has been so kind as to consult you, and several Others in the Case; whose Judgments, though I have all due Regard for, yet in the present Circumstances (though I give the Preference to_ Unction _in some stubborn Cases) I dare not encourage it in this: For my Reason at first, for beginning so mildly, was, that in this uncommon Case, we might by degrees, make some Judgment of the Effects of_ Mercury, _and then proceed accordingly: For had I not been prevented by the Accidents you have, by Dr_ Friend, _been acquainted with, I should have been very desirous to have gone at least to the Heighth mentioned by Dr_ Friend. _But since I find, by encreasing the Quantity of the Dose to a_ Scruple (_of which he has taken four_) it has not affected the Glands at all, or made him Spit the more; but his Stomach is much more oppressed by it, with vast Quantity of Phlegm, viscous to a degree I have not met with, and gives him more than common Disturbance, not to be relieved but by often Vomiting, to which purpose the_ Turpith, _has answered very well for the present: My great Fear is, all things considered, that if I should proceed to_ Unction, _and it should produce the same Effect, that it will be too many for him. If my Fears are too great, my more than common Concern and Friendship is some Excuse for me; as also I desire it may be to You, for this tedious Account from_, Sir,

Yours, _&c._ Feb. 22d, 1718. J. RUSHWORTH.

I not receiving, in due Time, an Answer to this, and the Patient being reduced to a great Weakness, and to so great a Disorder, that he could not bear Talking to, I writ these few Lines for him to consider of.

Dear Sir,

_As your Case now stands, I must own my self a Coward: Though Dr_ Friend _is much mistaken to think I am either unacquainted with, or fear the common Accidents that often arise in Salivating: But that irregular and uncommon Effects are, in extraordinary Cases, produced by_ Mercury, Hale’_s Case is to me a sufficient Precedent, of which I have formerly told you the Particulars; and though your Friends in Town took no Notice of the unusual Disorder in your Stomach, yet I should think myself Inexcusable if I should not. And if, upon using an_ Unction, _any irregular Ferments should again arise, weak as you now are, I should dread the Consequence. In these Circumstances, I think it most prudent for me, to advise you, to let what is already taken, go fairly off, and if you find it not effectual, you may with much better Prospect, when you have Strength, begin_ de Nova, _by_ Unction, _and have an Opportunity to have it done by the_ infallible _Men_.