The late Dr. Monro[133], from observing, that almost all the patients on whom, to his knowledge, the operation had been performed, relapsed, is inclined rather to adopt the palliative treatment, than the extirpation. He takes for granted, that, in the generality of cases, cancer depends upon some internal cause. In these cases, he is decidedly averse from the operation, and advises it only when the disease occurs owing to blows or hurts in young and healthy people. But, in considering this opinion, we are to remember, that a great many of these cases may be supposed to have been very far advanced before any operation was performed; and likewise, that the method of operating, in that period, was extremely unfavourable to a cure, the wound being kept open, and suppurations and ulceration rather encouraged than avoided. More lately, Mr. Hill of Dumfries has published an account of cases, where the operation was performed in more favourable circumstances, and of these not a seventh part suffered a relapse. The present Dr. Monro gives even a more favourable account; for, if I am not much mistaken, he observes, in his lectures, that not one-third of the cases in which he had been consulted, had relapsed. From my own observations, I cannot judge very accurately; because many of those on whom I have operated, came from parts at a great distance, and with which I had no intercourse; consequently, I could not hear of the result of those cases: But of the cases, the sequel of which I have heard, not a fifth part have relapsed; and in those the operation was performed at a period when the axillary glands had become diseased, but were not evidently so; and, therefore, were not extirpated; for, in all of them, the disease reappeared in the lymphatic glands. But, even from this relapse, the patients may be cured by a second operation. We may, therefore, conclude, that, if the operation be early performed, the majority will recover; and even although the disease should afterwards appear in the lymphatic glands, the patient is not incurable; for we frequently succeed in extirpating cancers, when the glands are very much affected before we are applied to. I have operated in cases where I was obliged to dissect the glands, from the axillary artery alongst almost all its course in the armpit, and which reached well nigh to the articulation. [133] Med. Essays, Vol. V. p. 422.