The Treatment of Cancer by Pressure.

M. Bouchut has recently introduced to the notice of the members of the Académie des Sciences a cuirasse of vulcanized caoutchouc, which he has used with success for the treatment of cancerous and other tumors of the breast. In this country there has been much division of opinion upon the utility of pressure in the treatment of cancer, some surgeons regarding it as harmful, or but rarely useful, others attributing to it great retardation of the rapidity of growth of the tumor, or even cure. The surgeons of Middlesex Hospital studied it systematically some years ago, and gave an unfavorable report. The theory of the plan is certainly good: a neoplasia, like a healthy tissue, is dependent upon its blood supply for vitality and growth, and complete anæmia causes the death of a tumor, as it does of a patch of brain substance. It will be remembered that Mr. Haward last year related at the Clinical Society a case in point. He ligatured the left lingual artery for a recurrent epithelioma of the tongue; the tumor sloughed away, and a fortnight before the patient's death from blood poisoning the tongue was quite healed. In just the same way ischæmia will impair the vitality and so lessen the growth of a tumor. The difficulty is rather in the practical application of this theory. The knowledge that we now possess of the mode of growth of cancers gives us at least one important indication. If we have to deal with a neoplasia that grows at the periphery by gradual infiltration of the surrounding tissues, it is plain that, for pressure to be useful, it must be applied around the tumor rather than over it, where, by compressing and obstructing the capillaries, it would cause overfullness of those at the circumference. It is the periphery of a cancer that is its active part, and we must, therefore, produce ischæmia around and not in the tumor. In the application of the treatment this must be obtained by the careful adjustment of elastic pads or cotton wool, and as the whole success of the plan depends upon the skill with which this is done, too much attention cannot be given to it. We cannot regard pressure as a substitute for removal of a cancer; but in the frequent cases where this is impracticable it appears to be the best substitute at present open to the surgeon. M. Bouchut's cuirasse would seem to be an improvement upon the spring pads and other appliances in use in this country.—Lancet.