Presentation

Bloodletting utensisls - Parisian studio 19th century - in repoussé silver. It contains 7 compartments for lancet, scissors, needle (and its glass case), spoon and pair of pliers - (Museum of Medicine in Brussels)

History

The History of Cancer

(Some History : From 1700 to 1900 A.C.)

The 18th and 19th centuries

• Galen's theory of "humors", now commonly accepted, will widely influence doctors :

 

Henri Francois le Dran (1685-1770)

observed that cancer developed locally and that it then spread to the lymph nodes through the lymphatic ducts.
This theory is of a great importance because it explains why for instance breast cancer can reach the lungs.
He recommended to excise the tumour AND the axillary lymph nodes. He knew that if the axillary lymph nodes were affected it was a serious cancer.He advised against the application of ointments on the lesion, which was a common practice in those years.

 

Xavier Bichat (1771-1802)

discovered that the different localizations of cancer could be attributed to one and the same disease affecting the same tissue but in different organs.

 

• Progress in Pathology : Cancer treatment is associated with the pathology.

 

Giovanni Battista Morgagni (1682-1771),

of Padoue, developed anatomopathology thanks to the dissections he practiced, no longer to localize different organs but to analyse the lesions that caused the death of his patient. He allowed a better understanding of cancer thanks to his work "De Sedibus et Causis Morborum", based on 700 registered cases and descriptions of autopsies carried out on patients who died from breast cancer, stomach cancer, rectum cancer and pancreas cancer.

 

Matthew Baillie (1761-1823)

published detailed anatomical descriptions in his atlas "The Morbid Anatomy of Some of the Most Important Parts of the Human Body". To illustrate this atlas, he drew his inspiration on the anatomical material of the Hunterian Museum in London.

 

Joseph Lister (1827 - 1912)

Acid Sprayer - Lister's Method (Museum of Medicine in Brussels)

• Experimental research in cancer treatment :

 

Bernard Peyrilhe (1735-1804),

carried out pioneer experiment on a breast cancer lesion : he withdrew some fluid and then injected it into a dog's peritoneal cavity.
In addition to his experiments, he observed that cancer first developed locally and that it then spread to other parts of the body through the lymphatic ducts.
As a treatment he recommended the excision of the "pectoralis major muscle" and the dissection of the axillary lymph nodes.

 

• Scientific Surgery

 

John Hunter (1728-1793)

was a great surgeon and filled the Hunterian Museum with his many dissections. Today, this Museum is still in the "Royal College of Surgeons of England in Lincoln's Inn Fields".
He was the first doctor to talk of predispositions to cancer like for example genetics, age, and maybe the climate. He estimated the average age at which people develop cancer 40 to 60 and found out that for a woman under 40 breast cancer was soon lethal.
He noticed that the breast, the uterus, the lips, the nose, the pancreas, the gastric pylorus and the testicles were the most frequently affected parts.

 

Astley Paston Cooper (1768-1841)

was Hunter's student and was very dedicated to the study of breast diseases. He described the fibrocystic mastopathy of the breast (a breast whose glandular part is hyperplasic).

 

Sir James Paget (1814-1899)

was a great surgeon. Among other diseases, he described Paget's disease of bone (osteitis deformans) and Paget's disease of breast, a type of nipple eczema associated with cancer.

 

Joseph Lister (1827-1912) of Glasgow,

applied Louis Pasteur's (1822-1895) theory introducing antisepsis and asepsis in surgery. He disinfected not only lesions and wounds (antisepsis), but also anything that was to touch the wound during the operation (asepsis). He used a spray to purify ambient air. Indeed, after an operation, many patients used to die from an infection.

 

To access previous parts of the text click on the links :

Introduction : click here
History : until 1200 A.C. : click here
Histoire : de 1300 à 1600 A.C. : click here
Histoire : de 1700 à 1900 A.C. : see text above
Conclusion : click here

Main sources of the text are :
- "The Theory and Practice of Oncology - Historical evolution and present principles" by Ronald W. Raven - Edition : The Parthenon Publishing Group - 1990 (Lancs - England / Park Ridge, New Jersey - USA)
- "Histoire du Cancer" (review "Histoire" n°74) by Marie-José Imbault-Huart