Medical inquiries and observations. By Benjamin Rush, M.D. professor of chemistry in the University of Pennsylvania.
Rush, Benjamin, 1746-1813., Redman, John, 1722-1808, dedicatee., Rush, Benjamin, 1746-1813. Appendix: containing, the new method of inoculating for the small pox.
Page  163

AN ACCOUNT OF THE EXTERNAL USE OF ARSENIC IN THE CURE OF CANCERS. Read before the American Philosophical Society, February 3, 1786.

A FEW years ago a certain Doctor Hugh Mar|tin, a surgeon of one of the Pennsylvania regi|ments stationed at Pittsburg, during the latter part of the late war, came to this city, and advertised to cure cancers with a medicine which he said he had discover|ed in the woods, in the neighbourhood of the garri|son. As Doctor Martin had once been my pupil, I took the liberty of waiting upon him, and asked him some questions respecting his discovery. His answers were calculated to make me believe, that his medicine was of a vegetable nature, and that it was originally an Indian remedy. He shewed me some of the me|dicine, which appeared to be the powder of a well-dried root of some kind. Anxious to see the success of this medicine in cancerous sores, I prevailed upon the doc|tor to admit me to see him apply it in two or three cases. I observed in some instances, he applied a powder to the parts affected, and in others only touch|ed them with a feather dipped in a liquid which had a white sediment, and which he made me believe was Page  164 the vegetable root diffused in water. It gave me great pleasure to witness the efficacy of the doctor's appli|cations. In several cancerous ulcers, the cures he performed were complete. Where the cancers were much connected with the lymphatic system, or accom|panied with a scrophulous habit of body, his medicine always failed, and, in some instances, did evident mis|chief.

ANXIOUS to discover a medicine that promised re|lief in even a few cases of cancers, and supposing that all the caustic vegetables were nearly alike, I applied the phytolacca or poke-root, the stramonium, the arum, and one or two others, to foul ulcers, in hopes of see|ing the same effects from them which I had seen from Doctor Martin's powder; but in these I was disap|pointed. They gave some pain, but performed no cures. At length I was furnished by a gentleman from Pittsburg with a powder which I had no doubt, from a variety of circumstances, was of the same kind as that used by Doctor Martin. I applied it to a fungous ulcer, but without producing the degrees of pain, in|flammation, or discharge, which I had been accustom|ed to see from the application of Doctor Martin's powder. After this, I should have suspected that the powder was not a simple root, had not the doctor con|tinued upon all occasions to assure me, that it was wholly a vegetable preparation.

IN the beginning of the year 1784 the doctor died, and it was generally believed that his medicine had died with him. A few weeks after his death I procured, from one of his administrators, a few ounces of the doctor's powder, partly with a view of applying it to a cancerous sore which then offered, and partly with Page  165 a view of examining it more minutely than I had been able to do during the doctor's life. Upon throwing the powder, which was of a brown color, upon a piece of white paper, I perceived distinctly a number of white particles scattered through it. I suspected at first that they were corrosive sublimate, but the usual tests of that metallic salt soon convinced me that I was mis|taken. Recollecting that arsenic was the basis of most of the celebrated cancer powders that have been used in the world, I had recourse to the tests for detecting it. Upon sprinkling a small quantity of the powder upon some coals of fire, it emitted the garlic smell so perceptibly as to be known by several persons whom I called into the room where I made the experiment, and who knew nothing of the object of my inquiries. After this, with some difficulty I picked out about three or four grains of the white powder, and bound them between two pieces of copper, which I threw into the fire. After the copper pieces became red hot, I took them out of the fire, and when they had cooled, dis|covered an evident whiteness imparted to both of them. One of the pieces afterwards looked like dull silver. These two tests have generally been thought sufficient to distinguish the presence of arsenic in any bodies; but I made use of a third, which has lately been com|municated to the world by Mr. Bergman, and which is supposed to be in all cases infallible.

I INFUSED a small quantity of the powder in a so|lution of a vegetable alkali in water for a few hours, and then poured it upon a solution of blue vitriol in water. The color of the vitriol was immediately changed to a beautiful green, and afterwards precipi|tated.

Page  166 I SHALL close this paper with a few remarks upon this powder, and upon the cure of cancers and foul ulcers of all kinds.

1. THE use of caustics in cancers and foul ulcers is very ancient, and universal. But I believe arsenic to be the most efficacious of any that has ever been used. It is the basis of Plunket's and probably of Guy's well known cancer powders. The great art of applying it successfully, is to dilute and mix it in such a manner as to mitigate the violence of its action. Doctor Mar|tin's composition was happily calculated for this pur|pose. It gave less pain than the common or lunar caustic. It excited a moderate inflammation, which separated the morbid from the sound parts, and pro|moted a plentiful afflux of humors to the sore during its application. It seldom produced an escar; hence it insinuated itself into the deepest recesses of the can|cers, and frequently separated these fibres in an un|broken state which are generally called the roots of the cancer. Upon this account, I think, in an ulce|rated cancer it is to be preferred to the knife. It has no action upon the sound skin. This Doctor Hall proved by confining a small quantity of it upon his arm for many hours. In those cases where Doctor Martin used it to extract cancerous or schirrous tumors that were not ulcerated, I have reason to believe that he always broke the skin with Spanish flies.

2. THE arsenic used by the doctor was the pure white arsenic. I should suppose from the examinati|on I made of the powder with the eye, that the pro|portion of arsenic to the vegetable powder, could not be more than 1/40 part of the whole compound. I have reason to think that the doctor employed differ|ent Page  167 vegetable substances at different times. The vege|table matter with which the arsenic was combined in the powder which I used in my experiments, was pro|bably nothing more than the powder of the root and berries of the solanum lethale, or deadly nightshade. As the principal, and perhaps the only design of the vegetable addition was to blunt the activity of the arse|nic, I should suppose that the same proportion of com|mon wheat flour as the doctor used of his caustic vege|tables, would answer nearly the same purpose. In those cases where the doctor applied a feather dipped in a liquid to the sore of his patient, I have no doubt but his phial contained nothing but a weak solution of arsenic in water. This is no new method of applying arsenic to foul ulcers. Doctor Way of Wilmington, has spoken in the highest terms to me of a wash for foulnesses on the skin, as well as old ulcers, prepared by boiling an ounce of white arsenic in two quarts of water to three pints, and applying it once or twice a day.

3. I MENTIONED formerly that Doctor Martin was often unsuccessful in the application of his powder. This was occasioned by his using it indiscriminately in all cases. In schirrous and cancerous tumors, the knife should always be preferred to the caustic. In cancerous ulcers attended with a scrophulous or a bad habit of body, such particularly as have their seat in the neck, in the breasts of females, and in the axillary glands, it can only protract the patient's misery. Most of the cancerous sores cured by Doctor Martin were seated on the nose, or cheeks, or upon the sur|face or extremities of the body. It remains yet to discover a cure for cancers that taint the fluids, or in|fect the whole lymphatic system. This cure I appre|hend Page  168 must be sought for in diet, or in the long use of some internal medicine.

TO pronounce a disease incurable, is often to ren|der it so. The intermitting fever, if left to itself, would probably prove frequently, and perhaps more speedily fatal than cancers. And as cancerous tumors and sores are often neglected, or treated improperly by injudicious people, from an apprehension that they are incurable, (to which the frequent advice of physi|cians "to let them alone," has no doubt contributed) perhaps the introduction of arsenic into regular practice as a remedy for cancers, may invite to a more early application to physicians, and thereby prevent the de|plorable cases that have been mentioned, which are often rendered so by delay or unskilful management.

4. IT is not in cancerous sores only that Doctor Martin's powder has been found to do service. In sores of all kinds, and from a variety of causes, where they have been attended with fungous flesh or callous edges, I have used the doctor's powder with advantage.

I FLATTER myself that I shall be excused in giving this detail of a quack medicine, when the society reflect that it was from the inventions and temerity of quacks, that physicians have derived some of their most active and useful medicines.