Through the Lens of Oncology History
A Century of Progress
The text and photographs on these pages represent the establishment of oncology as a viable medical specialty during the mid-1800s. The images and captions are excerpted from a four-volume series of books titled Oncology Tumors & Treatment: A Photographic History, by Stanley B. Burns, MD, FACS. To view additional photos from this series of books, visit burnsarchive.com.
In the last half of the nineteenth century, electrotherapy was a popular therapeutic modality. Every conceivable condition was treated with an application of electricity. Although the use of this treatment was often encouraged by the enormous lack of specific therapies for specific diseases, it was often safer than the toxic or narcotic preparations prescribed by the mainstream medicine establishment. Some doctors used these electrical treatments as an alternative to surgery. This choice sometimes helped their patients and other times proved fatal.
With the publication in 1889 of Conservative Gynecology and Electro-Therapeutics: A Practical Treatise on the Diseases of Women and Their Treatment by Electricity, Philadelphia gynecologist G. Betton Massey, MD, established the field of electro-gynecology. Dr. Massey, an early opponent of the improper use of surgery, believed electrical stimulation could correct various inflammations and tumors. He treated a variety of diseases with electricity, including breast carcinoma, rectal disease, and even ectopic pregnancies. For uterine disease, he often used a bipolar treatment with the insertion of a negatively charged electrode into the uterus and a positively charged electrode placed on the abdomen.
Although most of Dr. Massey’s concepts for the treatment of women’s diseases were ill conceived, there is no question he saved many from surgery and probable death from infection. On the other hand, others died from untreated cancer. His book was so popular that four editions were published until 1905. By the end of the century, however, the advances of surgical techniques, asepsis, and specialized instrumentation made surgery a safer, life-saving procedure. The image on page 178 shows Dr. Massey placing his external electrode on the abdomen, prior to the insertion of the uterine electrode for his treatment of “uterine disease.”
Dr. Massey declared, “Application of zinc-mercury cataphoresis offers a most effective method for the destructive sterilization of mammary cancer in its early stages ... without the risk of the infective cells gaining access to the lymphatic spaces, as may happen in a cutting operation.”
Dr. Massey details his treatment in the documentation of the following case:
Carcinoma of the Left Breast with Extension into the Axillary Glands. - Mrs. N.K. aged 44, was referred by Dr. J. J. Moylan, of Germantown, (Pennsylvania) in April 1899. This patient… presented an instance of acinous carcinoma of the left breast, though but a portion of the outer quadrant was affected. In this case, however, the disease had proceeded to a point of actual infiltration of the skin overlying the disease, and there was one enlarged, movable gland in the axilla, about the size of a horse-chestnut. She had noted the lump one year before. It was now giving pain, and her general condition did not indicate the best of health.
The patient was placed under ether April 13, 1899, and major cataphoresis applied, with the assistance of Drs. Hermance and Moylan. A large gold-mercury electrode was inserted, additional mercury injected, and a current of 400 milliamperes gradually turned on, encountering some trouble with the pulse again because of what is now understood to have been too rapid increase. Turning it on again more slowly we easily reached a strength of 500 milliamperes. After about a half-hour of steady current flow the whole lump began to soften, which softening included the whole growth at the end of an hour and twenty minutes. Meantime, a zinc instrument had been substituted for the gold one, as offering quicker results, and another zinc instrument had been made to penetrate the enlarged gland through its overlying skin, the current dividing itself between the two until the condition of the primary growth permitted the instrument in that situation to be removed.
The after-history of the case pursued the usual course, except that the general condition did not improve, and during the frequent postoperative examinations always made in such cases some induration was noticed in the axillary border of the main scar. This should have been destroyed at once, but the patient’s general health continuing poor, nothing was done. (The patient had this area treated by another physician with application of caustic paste. She died from metastatic disease soon afterward.)
It is amazing to note in reviewing several of Dr. Massey’s breast cases that he does not follow his own protocol for choosing cases and that although he is also proud of a patient’s results for the first 2 months or so, all his cancer patients died. He established a very large practice not only from physician referrals but also from direct appeals from patients who had had other surgeons recommend mastectomies.
It is understandable that a patient would perhaps seek “alternative or quack therapy” that does not require a major procedure. The treatment of cancer has always required drastic therapy and some patients in every era seek a shortcut to healing. A large number of physicians continued to refer cancer patients to Dr. Massey well into the early 1900s. This was a decade after the preferred treatment of radical mastectomy had been established by William S. Halsted, MD, and the development of radiation therapy.
In this era it was normal for women to be subject to clitorectomies and a wide variety of genital and reproductive system procedures for social reasons and psychiatric conditions. Hysterectomies were still controversial in recent times because the various reasons expounded for performing this procedure are not always medically sound. ■
Excerpted from Oncology: Tumors & Treatment, A Photographic History, The Antiseptic Era 1876-1900 by Stanley B. Burns, MD, FACS. Photograph courtesy of Stanley B. Burns, MD, and The Burns Archive.