"Brevity, indeed, upon some occasions, is real excellence."

Cicero, Brut. 13.50.

CANCER

Volume III

APRIL, 1926

No. 3

CANCER DEATH-RATE IN NEW YORK CITY DURING 1925

By L. DUNCAN BULKLEY, A. M., M. D.

In the April 1925 issue of CANCER, p. 223, was given my eighth annual statistical study of the death-rate from cancer, in New York City. During the past year the number of deaths from cancer again increased as I had foretold that it would, if the present dominancy of the unholy. trinity of surgery, X-rays, and radium were to continue in the treatment of the dreadful scourge. The Weekly Bulletin, published by the Department of Health, had ceased to appear towards the middle of 1925, and some of the issues which did appear, did not include the deaths from cancer. I have energetically protested against this condition of affairs and I have reasons to believe that the Bulletin will reappear again regularly and will include the deaths due to malignant disease. In the meantime, Dr. Wm. H. Guilfoy, Registrar of Records, was kind enough to supply me with the official figures, and I wish to express my thanks to him for

this courtesy.

The total number of deaths in 1925 from malignant disease, in all its forms, was 6,784;

a net increase of 227 over the number of deaths in

New York City in the previous year, giving a death-rate of nearly 110 per 100,000 population, which is a much higher rate than that of the corrected average for the preceding five years. The weekly rate of death has also increased, there being an average of 130; while last year the weekly average

was 125.

In last year's article on the same subject, I appended a chart, showing the comparative death-rates of cancer and tuberculosis for the last fifty-six years (1868-1923) in New York City, showing very graphically

13

CANCER DEATHS IN NEW YORK CITY, 1925.

Arranged according to age groups and contrasted with those of Toberculosis

85

1-2 2-3 3-4 4-5 5-9 10-14 1-14 20:34 2-2 30-34 35-39 40-413485-4g 50-555-57 60-64 65-66 70-7425-780-89

the rising death-rate of the red plague as compared to the falling rate of the white plague. While the tuberculosis death-rate has fallen to one-fifth of what it was in 1868, the cancer mortality has tripled. The accompanying chart, also drawn by Dr. Luttinger, shows that in 1925, the deaths from tuberculosis (all forms) again showed a material decrease, while those from cancer rose higher than in 1924, so that in New York City there were in 1925, 1309 more deaths from cancer than from tuberculosis. The same is true of the figures published by the Federal government and by the English authorities. (See CANCER Vol. III, No. 2, p. 160).

The number of deaths from cancer in the registration area of the United States during 1924 (the latest available figures) was 91,941, while in 1923 there were 86,754. An increase of 5,187. During the same year, the deaths from tuberculosis which were 90,732 in 1923, dropped to 89,724 in 1924, a decrease of 1,008. Thus, the deaths in the United States from cancer, in 1924, were 2,117 more than from tuberculosis.

These figures show unmistakably that there is a real, not an apparent, increase in cancer mortality, while tuberculosis, which is recognized as a medical disease and treated as such, is being gradually eradicated by the proper medical dietetic, and hygenic measures.

Of the 6,784 deaths from malignant disease, in New York City, 3,070 were among males and 3,714 among females. The larger number of females succumbing to cancer is mainly due to malignant disease of the female genital organs. This can be readily ascertained by studying the location of the neoplasm, which was as follows:

This

It can thus be seen that cancer of the genital organs, including the breast, killed 1,440 women or nearly thirty-nine per cent. If we abstract this number from the female deaths, we shall find that in regards to other organs, the mortality is about equally divided between the sexes. is strikingly illustrated by the number of deaths due to gastro-intestinal cancer, from which there died 1,831 males and 1,692 females. This and the larger number of cancers of the buccal cavity and of the skin, among

males, is apparent in all statistics. The latter has been attributed to greater exposure; but the only explanation for the great number and equal distribution of gastro-intestinal cancer, is that the digestive tract, and hence, man's diet has a good deal more to do with cancer than our surgical friends are willing to admit.

In referring to the Chart again, one can see that in regards to the age, the highest incidence is in the group 60-64. The deaths are more or less evenly divided in all age groups, except between thirty and fifty-four, when female deaths predominate. In the age group 45-49, there were 400 female deaths to 254 males. This group corresponds to the menopause and to the highest number of female genital cancers.

Conclusion: During the year 1925, there has been another increase in the number of deaths and the death-rate of cancer in New York City, as foretold. At the same time the deaths from tuberculosis have decreased. This state of affairs is due to the dominancy of surgery, X-rays and radium in the treatment of malignant disease. The preponderance of gastrointestinal cancer, about equally distributed in both sexes, shows that the main cause of cancer is probably due to errors in diet, which determine a constitutional inferiority, and which can only be combated by medical and not surgical measures.

CANCER AN INDIVIDUALISTIC DISEASE

Evolved upon the Basis of an Induced Heterogenicity to the
Species by Ultramicroscopic Infections

BY EMILIAN O. HOUDA, M. D.
TACOMA, WASH.

A recent rather bombastic report in the lay press, heralded as a new discovery of the cause of cancer, from the pens of a Dr. Gye and a Mr. Barnard of London, England, needs considerable toning down in so far as conclusions drawn. Considering the parallelism in the essentially important part of the report regarding the ultramicroscopic infection, with my prior publication appearing in the spring of 1924 and also in October of the same year, copies of which were received by London research centers,

there is an imputation in this paper that plagiarism has been exercised. In the October issue of 1924 of the journal CANCER there appeared an article under the title "Ultramicrobiosis in Cancer," the essentials of which, in modified form, are reported out of London as original with them. This article was condensed from "An abstract of the Cause of Cancer," written after many years of study, and this study of the subject directed along the line of a constant infection found in all cases studied during those years.

Copies of the original paper were sent to many parts of the globe. The research centers and some of the leading professional men in London received copies. The late Dr. Bashford of the Imperial Cancr research, was included in the number. Since copies of the journal CANCER were sent to London, in which the article on Ultramicroscopic Infection in Cancer appeared in the October issue, the year preceding the London report, it does seem singular that the contents would be entirely overlooked by research institutions.

The ugly imputation of plagiarism is further increased by the fact, that since the publication of the London report of last July, reprints were sent direct to Dr. Gye, with a personal letter, to which no reply has been made. Waiting many moons since then, it is highly improbable that any acknowledgement may be expected at this late date.

Interviews with Dr. Gye, as reported in the English lay press, state that he did not take up this line of research until eighteen months previous to the time of publication of his work, a period of time, the beginning of which was coincident with the receipt of American reprints by various institutions and individuals in London. It certainly does seem very

singular that in the short space of time of much less than eighteen months, that one who is not in medical practice should arrive as such sweeping conclusions; independently and without assistants.

For a period of time, covering more than fifteen years, I had been observing and studying these infections with the ultracondenser, assisted with a special illumination as described in the article of October, 1924 appearing in the journal CANCER.

These infections have been constantly found not only in the growths. and blood of cancer cases, but also in the fluids directly associated, such