I had assumed that the history of cancer would be pretty boring and not of much interest. But, after having read a book by Dr. Siddhartha Mukherjee called “The Emperor of all Maladies”, I think my perception has changed. The history of cancer is full of many interesting twist and turns. Here, I will highlight only a few and talk about how they affected the outcome of cancer treatment for many years.
Historical facts are highly dependent on beliefs of the time and cancer history is no different. What is surprising is how long old habits can last, even when it comes to life and death. In the area of cancer…this is quite striking. As I mentioned in my previous blog, the teachings from Hippocrates and from an avid follower of his, a physician named Galen, the theory of the four humors of cancer was very much in vogue. In Roman times at around 460 AD when Galen wrote his theories, cancer was thought to be due to an excess of black bile. The other three humors of liquids in the body incluced yellow bile (a cause of jaundice), Red or blood (too much caused blood related diseases) and phlegm (linked to many other ailments at that time). At that time levers and pulleys (remember, the Romans had an advanced system of carrying water into their cities) were used to explain how these fluids moved from one part of the body to another and how if disrupted or collected in excess led to diseases such as cancer. Galen’s teachings were so respected and so believable that they remained commonplace for over several thousands years. The other issue that was so galvanized into physicians minds for years to come also came from Hippocrates and Galen. That is that since cancer is a result of too much bile and that this black bile was everywhere, it made no sense to remove it. The black bile would only flow right back into the place that the tumor was found before it was removed. Galen had suggested that patients live longer if you just left the cancer in place. This dogma remained in place well into the early 1900’s when surgeons did attempt to try and remove cancers by cutting them out. Over and over again physicians would state how impractical it was to remove a tumor and how patients never recovered afterwards, so that this impossibility so it seemed remained entrenched for so long.
Actually, this may have been a mixed blessing. In fact, we now know that removing the cancer from the body was a risk and did cause death in patients nearly 100% of the time. However, this was rarely due to cancer but due to other factors. Actually, in reality surgery of any kind even minor skin surgery often resulted in death….it was not really an issue of cancer or not. There was no understanding at all of pathogens like bacteria that were all over, including the air. There was also no useful anesthetic for the longest time and alcohol and other spirits were often used, but they certainly did not dull the pain very much.
There were several turning points that finally lifted the veil off the idea that diseases were caused by humors alone (or even the thought that was common for thousands of years that the gods or somehow bad behavior gave you illnesses) caused diseases like cancer came from the detailed study of anatomy. First in 1533 and then again in 1793 two different notable physician/anatomists (the subject still very new in the mid 1500’s) made detailed observations of the human anatomy…describing/recording their meticulous finding in pages and pages of drawings. Neither ever found evidence for the three humors being compartmentalized in a way that they could cause things like cancer. In fact, black bile was never found at all. In the late 1700 and into the 1800 as more and more anatomists starting dissecting cancer after cancer from dead cadavers, it was quite clear that the issue of black bile simply could not be resolved and perhaps not trusted. This was a HUGE leap and not trusted by the clinical community for many years.
Ok..well that’s it for now…next I will talk about how anesthesthetics and antibiotics helped change things even more drastically!
Thanks and I hope you have enjoyed reading this. Please do visit Cancer Made Simple to find out more educational material on cancer!
- Cancer: a brief history! (simplecancer.wordpress.com)
- ‘The Emperor of All Maladies’: A biography of cancer, and hopes for a cure (seattletimes.nwsource.com)
- “How the ancient world dealt with cancer” and related posts (pagingdrgupta.blogs.cnn.com)