Cancer of the colon and Hydrastis canadensis
By A. J. Archibald

SURGERY is generally Medicine at fault; Medicine caught in a blind alley! Surgery calls for a physician’s knowledge and acumen; mastery of a complex, glittering technique; a proud handicraftmanship in which delicacy, dexterity, and nice accuracy of touch and movement are co-ordinated with skill and artistry. But all the same it is the physician’s confession of failure, from the first  doubts and hesitancies of Hipppocrates and Galen down the centuries to Ambroise Pare, Perceval Pott, Liston, Lister; right down to the white smocked, masked, deft handed surgeons of today.

Thoughts like these always assail the physician when he is forced to seek the aid of a  surgical colleague. He may wrap up his failure in sonorous terms; mechanical obstruction; structural or organic stenosis; molecular cohesion; but he cannot sidestep the impact of logic; he cannot escape the inexorable synthesis of theory and praxis.

Just such a feeling of defeat assailed me when I was forced to diagnose cancer of the colon in A.B.,  aged 70, a man of sweet disposition and high courage. A year before he had suffered from haemorrhage from the rectum, losing a good deal of blood. He had been examined by a skilful and  conscientious colleague, with all the resources of modern diagnosis, including sigmoidoscopy and radiography, but no irregularity was found; no tumour, ulcer, or any abnormality.

He complained to me of discomfort in the left lower quadrant of the abdomen; discomfort that frequently became rhythmical pain, traveling downwards and  ending in a thin stream of haemorrage or an exquisitely painful watery diarrhoea. He had been losing flesh and strength. The eyes were a little sunken; a little dull; a little anxious. Joy was oozing out of life; food had lost its savour; air and water their freshness; and resting was better than activity. All this sounded very ominous from a man not yet 70; a man who belonged to open fields and the great shires of the sky; a lover of animals; plain brother of the hills, hedgerows, and the birds. More ominous still was the report that tobacco had lost its taste; that his pipe remained unfilled when he sat over his evening beer.

I was not surprised to find a mass in the left pelvic region; a mass that was stone-hard, fixed and irregular of surface. And enlargement of liver, dullness and great tenderness over one of the dorsal vertebrae told me that already cancer cells were speeding along the arterial stream, seeking new sites and fresh breeding grounds.

There was little need for X-ray diagnosis. But a barium meal and a barium enema were given; only a tiny trickle of the barium escaped through the tumour region; a trickle like a thin, twisted wire, an escape that was made with great discomfort, difficulty, and, at last, agonizing pain. Here was evidence, if evidence were wanting, that the lumen of the bowel was compressed by an iron-like band of tumour cells. The mass was beyond the reach, though not far beyond it, of a finger passed into the rectum; widening or ballooning of the rectum was noted; and at times the examining finger was stained with blood.

For a time I looked at the elderly man from the viewpoint of an allopath, forgetting that I was something more! So hard does training, conditioning die! What could I do for him? Colotomy? In a day or two obstruction would be complete! Then vomiting, reversed peristalsis, distension, faecal vomiting, agonizing pain. But he was already weakening. Hollow eye, quickening pulse, deepening anxiety, all spoke of the reversal of life’s current. Further, colostomy meant surgical nursing, dressings, frequent changes of bed linen. And there was no hot water on tap; no cold water, even, laid on. True, his wife was there; slight, not physically strong, but a tower of moral strength. I knew she was tireless, efficient, capable of any sacrifice. But she dreaded surgical interference; prayed that it could be avoided.

Without pity no man can be a doctor. The kind of pity Wilfrid Owen had in mind when he wrote in the preface to his great war poems: “The poetry is in the pity.” But a doctor needs more than pity; more than healing touch; he must know how men live and get their living. And he must modify his methods of treatment accordingly.

I was not bold enough to think that I could bring health back to Mr. B. I saw no way of reversing the rapid cell-division that was building up tumour and forming metastases. I saw no prospect of quelling the rebellion that was flaring up in the dark among glandular elements which had hitherto obeyed the law and order that was life. Why were those cells seeking more abundant life along the via dolorosa that was death; defying discipline, order, sanity, health? Was it to escape the death that comes to all; to lowly cell, to peerless Helen, to all-conquering Alexander?

I decided to give A.B. Hydrastis Canadensis, using the 12^th, 30^th and 200^th potencies. I started with the lowest potency, raising the potency each day till the 200^th was given on the third day. There was an almost immediate response. He became quiet, peaceful, contented. Pain gradually died away, and the face lost its anxious look. And though the tumour increased – almost daily – in size, fixity, and, if possible, stony hardness, there was an almost daily movement of the bowels; movement without pain, straining, and with very little haemorrhage.

About three weeks before death the abdomen became suddenly distended. Peristaltic movements were grossly visible. Pain returned; the old rhythmic pain tending downwards from the tumour. Cancerous cachexia was plain. The old haunted, driven look appeared in the eyes. And nothing came from the bowels; not even a little flatus. Again I feared mechanical obstruction demanding colostomy. But I had supreme faith in my drug. Once more I gave him a 200^th and then ordered an enema. The result was a large motion.

After that he declined slowly and smoothly to death; without pain, without distress; passing quietly away in his sleep.