Rl t Herald Co. ANT ormetia ibe New ark {skin surface, though practically never see - HERE is naturally very great popular infersst in cancer. The diseise canses more then "one 1 thifty deaths, it ls said, and earries off "more victims than typhoid feve., smallpox, skariet fever, measles, whooping eongh and all the contagions diseases put togethes, There are very few people one 'may meet in our been alindet egal to the demand. Bowe of the information, however, has proved, to 'be therely hasty jumping to conclu sions not Justified by real knowledge. Much nitre of Jt has turned out to be sensational seeking after notoriety for 'ote Teasoh or Another, either on the part of seientific investigators, or much oftener on the part of those whose only ides is to make 'moiiey By their supposed dis- coverion. : Scarcely & month pagses without the snnouneement of 8 néw and wonderful discovery with regard to the cause and eure of ehnber, yet lie cancer deaths con- tinue and very little that Is practical seems to have been secommplished. Every pow and then the high character of the source df the news seems to indicate that the mystery hay surely been solved, but we find after a time that it is just as great a mystery as ever, and cancer con tines t Bo one of the most serious fac- tars in the human death rate. In spite of all the sccumulation of medical scien tie knowledge in recent years there have even been declarations, apparently founded on reliable #fatisties, that can- cer wih increasing rather than decreas ing. This, of outse, is mainly due fo the fact that with better knowledge can- ter is now more frequently and surély ' Many & patient died from jornil afiments in the past whose death was set down to somes con- stitutions} disease of 'a general character oF to some complication or' even 'to old age 'that tow Is definitely recognized as a death fsom: eaneer, - Population is so mith snore prowded and news better te- ported that 'we hear mach 'move fre: quently of deaths from éancer, but the only real increas has come from the tact (hat our better hygienic conditions are keeping alive longer than s few a and cancer ls s_dis- ease partiglstly of the time after mid: dle life. Mons people live to the cancer age and death inevitably comes to a cer- tain number 'of them in this form. Cause Not Known. In spite of the scarcity of such definite information as wquld enible us to prevent " or cure ¢ancer lu general, we now know enough abot it to be able to point out certain conditions that favor its appear ance in people "Who are predisposed to it so as te be able te suggest general pro. phylaxis aud, still more importait, to be able to quiet MANY fears and dreads with regard to cancer wiiieh make some sensi- tive people almost as miserable as if the disease were netually developing. "Probably the most important source of informa tion Wits tegard to cancer has been the investigation made by the Im- perial Cancer Resdureh Fund of England under the direction of the Royal College of 'Physieltnk of 1 and the Royal College of Surgeons of England, Their ' published not long ; p, valuable contribu- iy of cancer, of which we bave a Mutple®, bat to such actuar builds of Sheets as may be help: ful ? i : | servations. It was found that people -whof {work in tar and paraffin may have can- 'eer develop on portions of the skin sur- face subjected to constant irritation from !these products. Apparently all that i= needed in certain persons is the constant | preséuce 'of an irritant, and then esmcer time who have not lost| some friends by cancer. Information with * regard to It has been looked for anxionsly, . and the supply from seany sources has, #!ly just beneath where the little stove is THE DAILY BRITISH WIIG, TUESDAY, JULY 2. n » 1042, It Causes More Than One in Every Thirty Deaths and Carries Off $ More Vict ims Than All the Contagious Diseases Put Together--Is Not Fatal if Treated in' Time and Is Not on the Increase - - lin other people in the same situations. After this came » series of similar: ob- is likely to develop. It does not develop in all of the workers in a particular trade, nor even in a large proportion sof them, 4 but it is seen only in those who work at such trades, and the origin of it, particu- larly in 'parts of the body wheres irritants are constantly present in workers, though cancer almost never occurs in pther per-lgiseass develop it. Only a sons in such localities, makes it evident that the disease is due to the prolonged local irritation. = ~ Any form of chronic iriitalion, however, may prove the basis for the development of caticer, Sailors, who handle rapes and whose hands and arms.are much exposed to the inclemencies of the weather, de- velop certain chronic skin «diseases, in the midst of which cancer hasbeen known to develop, which by German suthorities has been spoken of as sailor's cancer, The customs of many nations furnish the basis of chronic irritation in which cancer develops. For instance, in' Ceylon and India the people have the habit of chewing a> Jreparation of betel nut. This consists of "the npt of the betel tree wrapped in the leaves of the.betel pepper plant. It is very hot and rather acrid and it is not a little dieult to understand just why the custom of chewing the preparation became so common. Ap- parently any strong sensation can after s time become a source of pleamire be cause of the attention that it arouses, The gum chewing habit, after all, is founded on the same principle, a certain low grade pleasure being derived from an occupation of the jaws and tongue and teeth, Apparently such oeccupatioh les- Auch mind as they have from being # burden to. them. . Betel Nut'Ch hy Some years agg it was noted that epe- [ of cancer:6f the tongue were much more frequent in Ceylon and India than elsewhere, and eventually the ori gin of these cancers was traced to the chronic irritation set vp during the proc ess of betel nut chewing.. The inhabi- tants recognize the danger now, but as only a small proportion of those who have the habit dévelop cancer the habit con- tinues to be popular and doubtless will remain for many years. There is no doubt about the connection between the irritant and the subsequent cancer, but people seem quite willing to face the risk so long as the danger is not inevitable and Attacks only comparatively a few of those who have the habit. . In China the people in many of the country districts have acquired the habit of eating rice very hot. This Is some- times so hot that it would -be.quite im-| possible for one unused to it fo hold the material in the mouth at all. Apparent- Ir vice has so monotonous a taste when used as a staple article of diet that those sens worries in some peoplé and keepa) secoml' soutce of irritation, develop can the mouth cancers seen id this country in women. Men indulge In many irritants of the oral mucous membranes--smyking, chewing tobacco, the alcoholic liquors, especially undiluted, and the like. v These irritations do uot cause cancer, use of pout "they * produce conditions i whicl | without eondulting a physician. If thes those who are predisposed to malignant omparatively who consume it in large quantities are! very glad to have even the change of stimulation of very hot food. Cancer of land 'ay' a' consequence most. men vids | of va' tooth, and these the tongue and of the mouth structures | is commen in regions where such hot} materials are eaten, and there is no doubt] of the direct connection between the chronic irritation produced by the hot! rice and the cancer development. A very curious custom prevails in Kash- mir, a district ih the Himalaya Moun: tains, which gives origin to a 'specially treme in the mountains and the varia- tions of temperature very marked. As a} teonsequence of this many of the people ln this district 'are in the habit during! the cold weather of wearing under their, rather loose dress a small portable chir-! coal stove. « This is usually fastened round the waist by a girdle and is ap- plied directly to the abdomen in front As a consequence of the intense irritation jset up by this heating apparatus cancer develops in these persons rather frequent, worn, Cancer in this location in the skin surface is almodt never seen anywhere | except in Kashmir, though it is not at all infrequent there. There can be no doubt, "of "the connection between the' chronic Irritation and the development of cancer. % Cancer of the v Tongue. Souae similar causative conditions have and over again it has been noted that 5 legen small spergenilage of men h sensation that is induced by the intense | dency. tp-eancor. less than owe-in twenty, | contin' to indulge in these rritants wit! No one tell beforehand r, Just who Las « impunity, Lowey has not a ¢ I predisposition, so that there is a certain amount "of danger the subjects of such habits, It is quip Ld Sure now that without these h ay cor of the mouth--that ix, Ds, tokue and the tonsils--and the Jarynx localized cancer. The cold 4s often ex- would Be tuch less freguent than it is{alwiys fatal, becanse at preseut. - Whether this lessening of cancer in th facia! region would not be compensate for by the ocenrpence of the disease in other parts of the body is pot quite sure Only such persons as indulge in the irei- a Ch ey i {tant habits (6 a gront excese are likely lorodues cancer to set up enough chromic irritation to oc. casion gancer. The man from mouth a cigar is almost gever during the day develops cadeer tongue 'or tonsils or larynx. The WRG way Bess 4 series of cancer developments PA with a short pipe, who has we ri down & tooth in a papticglar place or takes a vautage of a broke tooth in order 10 8% |g ieonment of concen At Srst when the to dege commodate if, gots canter of the tongee or of "the Up near the broken, jagged There are. other forms of chrobic ir) tations that tay prove the origi of can: "doer, or at lest furnish a site forit. Cer! tain lesions, sores, chronic evuptions abd the Tike Jieed to be watched carefully if they have contloned to exist for a con- siderable' period in spite of ressoniblc keep iS Ke i . . ' k | deawing hot smoke directly against thebof sores on tha ey end orsside of thestongue, the mouthpiece 8 at point ot 'the pipe offen heing rough and itself al brane meet--that is, 'where one form of |abdonfinal re cer at the imitated point. | Nearly all" of | passes over i ail who become | i this it i8 often practically impossible to ! % -{ covering of the ito the woist, softer muecons' i : t i membrane--that there is particular like- | : develop in-men; only rarely are they scenflihood of the development of these dis. tarbances of cell growth fhat we cali!develops This is parti caneer, Sores on the lips that refuse heal in sp alward susp dnd 'must uot be al lowed to continue for more than a week are somewhat indurafed, then this warn: 8 warn vug is parti important. Kiara mamta sii x - mes long: continued sores are : 2 ii dep sinbses that lead down to fhe 'root [tit do not readily de}™ generate into cancer, but on the edge of lips, and especially in the middle 2 4% either angle of the month, or at the i angle of the eyglic weiter altitude of mind 'hay br t { It is surprising how mausy people will | pgrmit a sore thai proves to be cancer us to run on for mpuths without giving!or begi 5 : x 4d eath the angle of the jaw and deep in: the tissues become affected, and after {remove the cancer completely, In véty recent tijges certain special in- bl tense forms of frefintion are known to A series of physicians nd electrical Ry a. devoted iand electrical experts who have devoted io, {#0 that iu spite of a succession of amputa- ids add: the lips, It{the vest pocket bas been 2° 8 where skin and mucous mem- | produced a burn of the ski surface of the surface, the dry gkiu, lopment of cancer. Any . sealor he, if Ita artis" wis prolonged, pro- scars that devel rdiuary treatinept Yrs "oqueRCe of swallowing {strongly caustic fluid. Danger of Pig Other areas where may readily) Quent areas of irritation. All through the 1 ee y er Nada 3 % id S€t up over prowotiged § sies. Pigmented| Ibtestinal tract it is at the Er Jevelop ied arks they sprea is, suspicion is a much: This is parti {elderly te tsimilarly dangerous. iple have no significance and are not dan- gtrous, unless for any reason they should} he very [{requently irvitated, or made to fien, when sometimes they take| gnancy that has a cancerous ten-| Warts on the face that are par teularly rich in blood supply may become! . gerons in this way with advancing whose ihemselves to X-ray work have developed years, but as a rule need give no anxiety, absent | hovnic skin Jiveases in the midst of which | Moles on. eather parts of the body thas on of the cancer has developed. Sometimes thereiibe face seldom give rise to cangers Ap utly the irritation of light and heat obs of temperature, as well Eosonp and the irritation of ofl ma dency. {as wash ons death finally took place from furiber!ay.. { [ X-rays, which Bad been Balled as a cure! [for enancer, begah to cause that disoase the | {world was startled, but wekuew now that {it Is only: the intensely irriiant effect that, ibrimge about fis development of the can- : jeer. { 1 Purn, and it is ties that proves ue faceasion for cancer development (instance, that = tore intensely irvitant thon the semp of |" to the jure Ans! inmianee, | Bears almost anywhere in the body are | cancer, fhrouzh maliguafit developments come. abott. 8s a rule, only in sears tind Tepe rac and that, there irritation raver The star ¢f an Xray burn. is oniz]a tendenes to rout ev son, with s similar produce scars ine op in th nt cancerous tend Prati pitino a #8 BY JAMES J. WALSH, M. D;, PH.D, LIT.D BE ri=d to Have eiéguent devel- austic, however, Fort of burns made by! 7 Mich cancer often! snted Spots. Sonie irritation is Some-| spots, for instiute, arcr ICU arly likely! then bresking down again, are oftenasites of cancers, Cancer of the\stomach very frequently develops on the site of an old ulcer. The presence of gall stones sets up a chronie'irritation in the gall bladder often followed by cancer. . Cancers in the digestive tractausyally tion. For instance, in the esophagus can- {eer occurs particularly just | swallowing tube is rif sony 1s it passes | through the diaphragm. In 'the stomach arly 'true of the! is gocurs with the greatest frequemey at throat as a com-/ . . i the pylorus, or gateway: that is, 'the place 73 accident some | of exit for food from the stomach. It is { here that unchewved portions oft food with {rough edges or pieces of bone or other hard materials are likely to produce fre where irritation from rough msserials in _ ithe food is likely to be most noted tha "jecancer occurs with greatest frequency i Practically all the . structures, of the human body that are especially+liable to cancer have a history of frequently re- | peated irritations, and these seem to form |» basis of that change which cones over i the tissues and produces whatswe know {as cancer. The essence of that change' is a ten. {dency for certain kinds of cells to over ! grow. There are two kinds of'vmalignant | disease, or cancer, as it impopulmrly called. | One «of these is sarcoma, which develops {in the connective tissues and isvsedn par- ticularly during the younger years before full growth has been attained. The other is carcinoma, which develops in: the epl- thelial or glandular tissues; that is, those struetures "which producq various. sib- stances for the use of the body. Health consists to a great extent in a state of peace and co-operation between these two kinds of tissues, the comnective tissues and the glandular tissues. Whenever either of them overgrows at the expense of the other the whole or ganism suffers, The connective tissues are much less important than the glamdu- lar tissues, for they omly support and help to move the body, while the glands perform, the wonderful chemical work with its fine adjustments on which hu- man nutrition depends. During the growing period the connective tissues are very important and receive an abundant i putritive supply, and consequently some- times overgrow locally with the produc. ition of malignant tumor, the so-called {sarcoma, Later in life the glands get | most of the nutrition and then they may { cancer. The Fatal Delay. " It Is not surprising, then, that cancer {should have been described as a sort of !rebellion or revolution in the tissues. | When the supporting cells, which inay well be compared with the working (asses, receive thelr due amount of nu- {trition and carry on their work, without wishing to absorb more than their share 'of. the nutrition of the body, then all is {well When the glands, the aristocracy, as it were, of the body, the chemists and gther professional men, the directors and administrators of various functions, are willing to take their proper share, but no more, then the body is healthy. In the younger years sometimes the connective tissues claim more than their share, over- grow at the expense of the neighboring tissues and usually kill the organisg to which they belong. Later in life the glandular cells may make a similar mis- take, and, insisting on more than their share, may produce like serious effects, We know that heredity has a certain very definite but limited place in pre- disposition to cancer. the efuilibrium between the various tis-| sues in the body which represents health may be disturbed by some defect in ihe nccur at the points most subject to Brrita- here thes { overgrow, with the production of true It is evident that) r -- --_-- been found 1s thekmife. That seems a rather rough: way ofjpurting it, but it in fthe only true way: And since cancer is an affair of life and desth we must pot wince matters. External caneet can ues Ye curedfby tHe kuife completely if it only be taken in time. Unfortu. 'vately, peoplp hesitate and delay and tem Porize in various ways and fea~ to know the worst, mntil often the cancer reaches hsueh A =tojge that it cannot be removed feompletely, and then death is practieally nevitable, The. report of the Commis. beion on Cancer of the State of Fennayle Fvania for last year covers the statisties pof four hundred patients from variouy foarts of the State. When the cases of external cancers presented themselves for treatment. Jess than seven out of ten 'were suitable for operation Many of the patients had been aware of the pres. ence of the condition for considerably more than a year before they applied to the surgeon" for relief. Delay probably leads to the fatal terminatioz of at leght one-half of al, cancer cases. Even when the condition is suitable' for operation, often it has been sllowed to progress so far that infection has taken place deep in the tissues, so that, though the exter nal tumor can be removed, recurrences take place in other parts of the body, Best Medicine Ts Knife. Many a cured cancer patient owes his cure to. bravely facing the danger, re- fusing to put off in cowardly fashion the knowledge of the worst, and then having the operation performed promptly. Some of the exteraal cancers. can be treated successfully by plasters and pastes and caustic applications of va. rious kinds. Indeed, some good authori ties prefer these modes of treatment | for forms of external cancer. It is ex- tremely important, however, to have these applies tions made by expert hands, It ls always suspicious when the appli- cations are made by those who Insist on how much can be sccomplished for the eatment of cancer without the use of the e. Any oné who knows cancer well ust recognize that the cleanest, best medicine we have for it is the knifd. Those who pretend to any other opine fon are likely to usé their various appli- cations under circumstances where they cannot do good, and unfortunately death is the penalty for a mistake of this kind, aud the wasting of precious time means an fipevitable fatal termination. Some external cancers must be treated by the knife. The physician who takes up their treatment then had better be ome whe is ready, judiciously and Judicially, to select that mode of treatment which 1s likely to do most good. He must not be wedded to any one form of trestmént. Even the man who is too ready to use the knife may make mistakes, and he should be willing to employ other mesns where they may do good. As a rule, sur gery is the least painful, the quickest, the surest, the most satisfactory form of Mreatment: of cancer, and it leaves the least scar; The Death Rate, The most serious factor in the death rate from cancer at the present time is undoubtedly delay in the proper tréatment, Probably three-fourths of all cancers could be radically cured if treated in time. Nine-tenths of all external cancers could surely be eraditated, Most of the delay is due to the fear to kiow the worst and the failure to realise the awful significance of the condition, but not a little is due to the use of fraudulent so- called cancer cures, advertised as such, promising results without pau and with- out operation, These frauds are allowed { by our laws to appeal through the various j advertizing mediums, and those who are j afllicted with cancer, or fear that they are 180 afflicted, grasp at a straw and the hope me 42 csties. Disease is not hereditary, put| Of easy cure, and by the time they have ronal cander. Some- ;.¢ al moles of birth. oo ifibrinm may be transthitted from one] , And sometimes ects are, Certain defectiveness in cell generation to arother, and this represents arcas 'that develop (p. predisposition: to cancer which evi 't Such spols are Very g.n¢ly must be present before the malig r and show any teddency to 1 they shodld be promly removed, larly. important advice for A pigmented spot that js is superficially situated in need not give any solicitude, but Lierent to the underlying tissues, to 'be, or if it shows any ten- it proper attention. To do so is nearly dency to extend its borders, these are dan the glands be- Ber signals. Pigmented warts in older people are Warts in young peo- He, ted a" ke these birtSmarks move liable rate mali-~anily. Results of Scars. frequently the site of re, Affe CoNAIADIY 8 souree ol "constantly in thelr mouths, care of hem. This is particularly truejthe sdme thir Wren vadingd exrvied in| existed for a sit issues ia the midst of which they The sears afters burh, for the site of cancer fre- {other firm of intenss irritation, ss. for] quently creugh to have attracted special up by radivm, will do gitestion tw them, Sknr * ® 4 Deen ulcers that have cod while, healing and; The only ¢:re for cancer that bas yet f= nant process is set up. An English imperfal research commis sion has dwelt particularly on the ques tion of the increase of cancer. This re ported inerease is causing great solicitude dmong sensitive people. Iu its last report the commission says: -- "For the first time it is fully demonstrated that it is-errone ous to make statements of a ding ieting nature about the increase of cancer in general" Cancer in some parts of the body, as for instance in the tongue In men, is ap parently increasing, but the editor.of the report ventures to doubt the significance of the figures and thinks that they require further study and 'elucidation. A signifi cant increase has come in the digestive tract, but this is evidently due to the fact that the diagnosis is better than It used to be and that eapcer.is now recognised where not so long ago much more general diagnoses were mede. Cancer on the skin surface, where it bas always been easy to recognize it, shows Httle or no increase. {In general, wherever cancer may be ob wrved locally the incresse in cases is no more than might be expocted from the growth of population and the fact that fives and pass more years in the higher cancer aggs. Every year after thirty that a person livres increases the lability of death from eanccr, Unfortunately, after all fhe investigs- tise very Jittle can be said as fo the cure of cancer. A few cures are supposed to have bees discoyered by serious medjeal investigators, Lut experience with them has proved a disappointment. people are generally mow living longer, | been undeceived jt is too Inte to have a radical operation done. Not a few people { who are not sufferers from true cancer, but who have some form of tumor or swelling or chronic sore, apply to thess, cancer curers and in the course of time their condition passes away. These are the so-called cured cases so much adver. tised, They were not true chnosrs, but only some lesion thought to a cancer by a timarousg paticet\and nce such by Somevis" ¢itbr~itenpable of judging or whose personal interest die tated agreement with the patient in the matter. Many.of these people alter "the cure" is over go around for years with the burden of dread over them lggt thele cancer should return, Te It is evident that cancer is a condition that capnot be temporized with, and hat if its treatioent is put off will surely bave a fatal teomination. Just as soon as that fact is brought home to the great mass of the people and the additional one that there are no simple, paialess curey for maticer, and that any ame who piomises {such is a frond, scheming to make money, {but not 10 do any good, then our desth rate from cancer will fall fo a werked degree, We have any nfimber of casés now of record of patients who undonbt- edly bad eancer, who were operated. upon or properly treated by sowie Caustic: or {other adequate method, who sre alive from ten to twenty years after the: enn cerous condition was first diagnosed, There are many who died after operation under ten years, but whose deaths wers due to something quite different from cane cer and whose lives were evidently sot shortened by their. malignant disease: In a wond, cancer iv By no seats the bope- jess condition It is sometinres declared to be, avd 'we need only the proper diffusion of our prevent Information with regard 1 the disease to make ka mortaliy Jess than #f Bag been, EE Ta xX