SPECIFIC TEEATMENT OF CARCINOMA. 397 



GEOUP II. — CASES PKOBABLY CUKABLE BY OPERATION. 



Case 1. — No. 8505. Filipina aged 50 years. Ulcerated buccal carcinoma 

 with metastases to cervical lymph glands. Operation December 1, 1909; com- 

 plete removal of all carcinomatous material and glands of neck and closed by 

 plastic flap. Inoculation of cancer vaccine December 1, 1909. No indications 

 of recurrence have appeared. 



Case 2. — No. 8162. Filipina aged 45 j'ears. Medullary carcinoma of right 

 breast with involvement of skin and axillary glands. Operation by Dr. Schiff- 

 bauer October 13, 1909. Jackson operation for complete removal of breast and 

 axillary glands. Inoculation of cancer vaccine October 13, 1909. Patient was 

 heard from December 28, 1909, at Avhich time there were no signs of recurrence. 



GEOUP III. — CASES OF I>OUBTFUL CURABILITY BY OPERATION. 



Case 1. — No. 8197. Filipina aged 44 years. Adeno-carcinoma of left breast 

 with involvement of pectoral muscle, skin, and axillary glands. Operation by 

 Dr. Schifl'bauer October 20, 1909. Jackson operation for removal of breast, 

 pectoralis major and minor, and axillary glands. Inoculation loith cancer vaccine 

 October 20, 1909. Patient was still well on January 3, 1910. 



Case 2. — Filipino aged 67 years. Adeno carcinoma of right breast involving, 

 by metastasis, fully one-third of pectoralis major muscle, and the axillary and 

 retroclavicular lymph glands. Operation December 6, 1909; excision of breast, 

 outer half of pectoralis major muscle and majority of axillary glands. Inocula- 

 tion with cancer vaccine December 6, 1909. No signs of recurrence January 

 3, 1910. 



QKOUP IV, — POSITIVELY INOPESABLE CASES. 



While it is too earl)^ to draw any conclusions from any of the above 

 cases the results we have obtained in the cases presented in this group 

 are already of significance. 



Case 1. — No. 7052. Filipino aged 51 years. Recurrent carcinoma of right 

 cheek. This patient had been operated upon in the clinic at St. Paul's Hospital 

 and the growth had promptly recurred within three weeks' time, while the patient 

 was still an inmate of the ward. At the second operation only a portion of the 

 growth was removed to use in making a vaccine, as so much tissue had been 

 sacrificed at the previous one, that a plastic operation the second time was 

 impossible. No vaccine treatment had been given at the time of the first opera- 

 tion. Second operation and inoculation with vaccine were made June llf, 1909. 

 On December 29, 1909 there were no signs of further growth or recurrence in the 

 cheek, complete healing of carcinomatous areas having taken place, with disap- 

 pearance of thickening. 



Case 2. — No. 8175. Filipino aged 45 years. Ca,rcinomatous cyst of left neck 

 involving, by metastasis, all deep structures including deep vessels, also the 

 overlying skin to a marked degree. Operation November 6, 1909; tumor removed 

 as completely as possible by block dissection of neck; carcinomatous material 

 remained at upper angle of wound, adherent to upper segments of trachea, an.i 

 to greater corner of hyoid bone. Inoculation with cancer vaccine November 6, 

 1909. Three days after the operation a nodule was noticed at the upper angle of 

 the incision, the nodule measuring 2 centimeters in length and lying about 3 

 centimeters from the line of incision. The nodule was immovable, hard and lay 

 evidently below the skin. It increased in size until, on the seventh day after the 

 operation, it was distinctly larger and less movable. One week later it had 



