What Was Cancer? Definition, Diagnosis and Cause

Definition Cancer

Published in 1721, Nathan Bailey’s Universal Etymological English Dictionary demonstrates the complexity of early modern perceptions of, and terms for, cancerous disease.. Not everything that looks like a cancer is a cancer – ‘Carcinodes’ merely imitates that disease – but it is unclear on what basis one can differentiate between ‘real’ and false cancers, or spot a cancer in the first place. Moreover, Bailey’s dictionary only scratched the surface of the variance seen in texts discussing cancer, which included differences in terminology and definition almost as numerous as those who wrote them down. The project of this chapter, therefore, is to determine how we should understand early modern cancer(s). Can we treat ‘cancer’ as a single disease, with a single name? What made this disease different from others with similar symptoms?

In the Introduction to this book, I noted that studies of the history of cancer have often taken a retrodiagnostic approach, applying modern medical knowledge to pre-or early-modern experiences of disease. This tendency has been most prominent in the common assumption that Medieval or Renaissance physicians and onlookers possessed a view of cancerous disease which was simply a less sophisticated version of that found in modern medicine, and that they made ‘right’ or ‘wrong’ decisions about diagnosis and treatment from that viewpoint.Even in the latest and most comprehensive study of cancer in the early modern period, Marjo Kaartinen’s Breast Cancer in the Eighteenth Century, the focus is firmly on the experience of cancer patients once they had been diagnosed, and as such, the author devotes only 4 of her 124 pages to examining the definition and diagnosis of cancers.Departing from these treatment-focussed histories of cancer, I will argue that in the long seventeenth century, discussions of the etymological roots, cause, and symptoms of cancer were central to the discursive creation of the disease. Furthermore, these discussions took place in literary as well as medical texts.

Diagnosis Cancer

To date, analyses of the meaning of terms such as ‘canker’ and ‘cancer’ in drama, poetry and polemic have been surprisingly few. One of the most in-depth discussions of the significance of ‘canker’, Jonathan Gil Harris’s article on Gerard Malynes’s 1601 A Treatise of the Canker of England’s Common Wealth, focuses largely on the disease’s connection to the canker-worm, and as such is detailed in Lynette Hunter, meanwhile, speculates on the meanings of ‘canker’ in Romeo and Juliet, and notes how, in that play, the Friar and the Prince ‘deal with different kinds of canker: the canker that is the closed-over but ulcerous wound and the canker-worm that consumes the plant from inside its stem’.While Hunter argues that both kinds of canker ‘have the ambivalent potential to be at the same time internal contamination and external infection or contagion’, she views medical ‘cankers’ as referring to ulcerous wounds in general, and thus overlooks the rhetorical potential of malignant cancer, of which ulceration was merely one symptom.Sujata Iyengar’s Shakespeare’s Medical Language comes closer than Hunter’s analysis to describing the full potential of ‘canker’ as a term which might describe several kinds of horticultural or bodily disease, emphasising the ‘figurative implications’ of a disease that ‘kills or corrupts from within, sometimes unseen from the outside’.Like Hunter, however, Iyengar views the ‘canker’ of an ulcerated wound and that of a malignant tumour as ‘not readily distinguish[ed]’ by early modern medical practitioners. In this chapter, I argue that despite lexical confusion between the two categories, the majority of printed medical texts did in fact show a clear understanding of the difference between ‘cankerous’ ulcers caused by wounds or complaints such as venereal pox, and the more serious disease of cancer.

Cause Cancer

As will become clear throughout this book, all aspects of the conceptualisation and experience of cancer, from diagnosis to treatment, were closely intertwined. Moreover, theories about the nature and causes of cancer were often uncertain and conspicuously incomplete. Nonetheless, this chapter examines three areas which we might think of as providing the basic framework for an understanding of cancer: discussions of what the disease should be called and why, opinions about where a cancer could occur in the body and what symptoms it might produce, and debates over the efficient causes of the malady. First, I examine the etymology of the term ‘cancer’ and how the disease of cancer was signified in language. The proliferation of early modern terms for cancer presents, as I discuss, both a challenge for the modern reader and a question over how far this disease can be imagined as a coherent concept. Equally, however, the rich etymological and linguistic ‘life’ of cancer contributed to the construction of that disease as a singular and unique malady. In the second part of the chapter, I look at the bodily locations of cancer – where it might occur on or in the patient – before outlining some of the most common markers by which this disease was distinguished from more benign lumps and bumps. Finally, I explore the ways in which cancer was imagined as a disease with complex humoral origins, based primarily in the much-maligned humour of melancholy, but often also associated with yellow bile (choler), and the burning or ‘adustion’ of natural humours into harmful and destructive substances.

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