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 Breast Cancer: Revisiting Accepted Wisdom in the Management of Breast Cancer - Part 1 
 

Then and Now: History of Cancer of the Breast
The earliest known chronicle of breast tumors was recorded on Egyptian papyrus more than 3000 years ago, but no treatment was described. During the Middle Ages, mastectomy was wielded as tortuous punishment against women accused of religious or political deviation, such as Saint Agatha, patron saint of the breast. In France in the 1820s it was hypothesized that certain personality dispositions were considered to be more prone to breast cancer than were others. Women with a "bilious constitution and a dejected, melancholy character," for example, were especially predisposed.14 In Italy in 1842 Domenico Rigoni-Stern analyzed statistical data from death registries and noted that breast cancer incidence increases with age, and that unmarried women are at greater risk than married women.') Judgments that blamed sad or angry women for bringing breast cancer on themselves as well as the prescient insight that childbearing affects the incidence of this disease both occurred more than a century ago, repeating echoes across a historical canyon.

One of the earliest recorded nonpunitive mastectomies was performed by the accomplished surgeon James Syme (whose daughter married Joseph Lister) in a surgical amphitheater in Edinburgh in 1830. Dr John Brown, recollecting the event in 1863, tells us,

Allie stepped up on a seat, and laid herself on the table ... arranged herself, gave a rapid look at James [her husband]' shut her eyes ... and took my hand The operation was at once begun; it was necessarily slow; and chloroform--one of God's best gifts to his suffering children--was then unknown. The surgeon did his work. The pale face showed its pain, but was still and silent.... It is over: she is dressed, steps gently and decently down from the table, looks for James, then, turning to the surgeon and the students, she curtsies--and in a low, clear voice, begs their pardon as if she has behaved ill. The students--all of us--wept like children; the surgeon wrapped her up carefully, and resting on James and me, Allie went to her room.4

Four days later, Allie Noble developed an infection that she did not survive. Surgery was excruciating and death from it a likely possibility before anesthesia and asepsis. Interestingly, Symes also noted in 1842: "The result of operations for carcinoma when the glands are affected is almost always unsatisfactory, however perfectly they may seem to have [been] taken away. The reason for this is probably that the glands do not participate in the disease unless the system is strongly disposed to it."4(p650) British breast physician Michael Baum4(p650) comments that "[t]his statement is of great historical significance for two reasons. Firstly, it illustrates that surgeons long before the Halsted era were attempting perfect clearance of the axilla. In addition, it also illustrates that they recognized that such efforts were futile in the presence of extensive involvement, a sentiment that was ignored for a further 120 years."

Accidents in which women's breasts were caught in the wringers of old-fashioned washing machines were commonplace. After such a mishap, women would visit their doctors because of tenderness, swelling, and pain. Probably because an existing lump was noticed following such an accident, it was supposed that breast cancer was caused by trauma. This is one early example of the coincidental being mistaken for the causative. But for the most part, before routine palpation or mammography, breast cancer was not recognized by subtle signs. Instead, women suffered from glaring complaints, such as oozing ulcerations and the malodorous weeping of distended, deformed, throbbing, eroded flesh. Such agonizing symptoms, even more than implacable death, caused the worst despair. In the context of the times, it was highly desirable to seek a cure for these symptoms--to remove the field upon which the game was played, annihilate the messenger (if not the message), and abort the short-term pain (if not the final demise). Today, though there is a pervasive amorphous panic, a spiny dread of death, in this country there are never open, rank, leaking wounds.

(Excerpted from Alternative Therapies in Health and Medicine)
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 About The Author
Harriet Beinfield LAcHarriet Beinfield, L.Ac. and Efrem Korngold, L.Ac., O.M.D. have pioneered the practice of Chinese medicine in America for the last 28 years as educators, writers, and practitioners. They are the co-authors of the......more
 
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