diagnosed cancer, and a surgeon of prominence in one of the large hospitals had strongly pressed for immediate operation, as the only hope, which was refused.

At her first visit there was a hard tumor 2 or 3 inches in diameter, sharply defined and nodular on the surface, in the upper segment of the left breast, with large, hard glands in the axilla. She had long been constipated and passed only about 60 per cent of the amount of urinary solids proper for her weight and age. Under very active treatment it was recorded 4 weeks later that there had been hardly any sensation in the breast during the previous week, whereas for the previous months she had been kept from her work in school by severe pain in the breast and axilla. The tumor had already diminished materially in size, with only moderate hardness, and she was feeling very much better, and out of doors every day, and she was again at her duties in the school. On April 7th it was recorded that the left breast was the same as the other and that no glands could be found in the axilla, and in my first report of the case in 1915, she had been free from disease for over 9 years. A sister, aged 60, had just then died of cancer of the stomach in a distant country town. At the last record, over 17 years from her first visit, she still remained free from cancer.

Case IV. Primary cancer of the left breast, well for 17 years. Miss J. N. A., aged 45, a hard worked city missionary, under great mental and physical strain, was referred to me October 12, 1905, for a tumor in the left breast, above the nipple, which had existed for some months, awaking her at night with pain, and also a numb, shooting pain in the day time. She had been seen by several medical men and surgeons, all diagnosing cancer, but she had declined the operation constantly urged.

Under rigid dietetic, hygienic, and medicinal measures the pain had entirely ceased within 2 months, and there was very little of the trouble in the breast. She was then repeatedly seen for 9 years, always in active work, and was then reported as cured. Seen recently again she was still in perfect health, with absolutely no remains of the tumor, fully 17 years after her first visit.

Case V. Primary carcinoma of the right breast, well for over

16 years. Mrs. B. E. C., aged 44, first seen September 19, 1892. She then had a flat tumor in the outer lower segment of the right breast, rather sharply defined and tender on pressure, which she had noticed about two months. Not satisfied with my diagnosis of cancer, and hesitating at the prolonged treatment proposed, she consulted a well known, very prominent surgeon, who pronounced the tumor unquestionably cancer, and urged its instant removal. I did not know of this until she informed me of it, some time later, after the tumor had entirely disappeared under medical treatment.

Under very active measures, with frequent visits, the breast became entirely normal in six months. The case was watched for over sixteen years, and at the last record she continued entirely well, with no recurrence of the breast tumor or metastasis.

It is needless to multiply greatly the histories of these cases, all so similar, for I find dozens of instances where the disease had remained cured five years or more, when they were lost sight of, with the injunction to follow out dietetic and hygienic regulations, and to report at once if there was the slightest reason. One or two more interesting cases may be referred to.

Case VI. Primary carcinosis of the left breast, still well 9 years. Mrs. J. T. T., a farmer's wife, aged 38 years, was seen in Norfolk, Conn., August 11, 1914. She had been confined with her first child 4 months previously, but had not nursed the child, and had no breast trouble. Four weeks before her visit she had noticed a tumor in the upper, outer segment of the left breast, increasing rapidly. She had seen an excellent surgeon in a neighboring city, who diagnosed cancer, and urged instant operation.

When first seen there was a mass the size of an egg, hard and well defined with enlarged axillary glands. Under very active dietetic, hygienic, and medicinal treatment, of various kinds the lump disappeared slowly, and just a year subsequently it was recorded that the breast was perfectly normal, with no trace of the tumor or axillary adenopathy. She was again confined of a healthy child in June, 1916, and the surgeon who confined her, and who had made the original diagnosis of cancer, and had urged instant surgical removal, reported the breast per

fectly normal, as I found it to be. She was seen frequently and the last record shows that the breast and axilla still remained perfectly well and free from cancer, 9 years after her first visit.

Case VII. Primary cancer of the right breast, well 6 years. Mrs. S. J., aged 33, first noticed a lump in the right breast two years previous to her first visit to my Hospital Medical Clinic for Cancer, February 28, 1917. This had steadily increased in size until seen, when it was fully an inch and a half in either direction, in about the middle line, above the nipple, with sharp, rather hard edges, and a palpable gland in the axilla: she had been having sharp pains, radiating from the breast to the axilla. For future reference I called in the cancer surgeon in attendance, who at once recognized it as carcinoma and urged immediate removal as the only hope for the patient.

She was extremely constipated, the mouth dry and the saliva acid. Being placed on strict dietetic, hygienic and medicinal measures, it was recorded in 2 weeks that she felt better than for a year. The lump was materially smaller though the edges were still sharp and nodular. There was no pain except on extreme exertion, in doing her own housework, and caring for two small children, who always accompanied her. She was very faithful to treatment, coming every week, and six months later it was recorded that the mass had markedly diminished, it being about an inch in diameter, very shallow, and with absolutely no pain. Six months later practically nothing could be felt, and no adenopathy.

A little over a year after her first visit, a physician visiting my clinic was told that she had cancer, and was asked to tell which breast was affected. After careful examination he decided that it must have been the left, instead of the right, as there was a slight chronic mastitis there. At intervals later four other physicians and surgeons made the same mistake in diagnosis. Within the first year my patient had been again pregnant, the child dying soon after birth. She reported faithfully for observation and some treatment for 4 years, and still nothing could be found in either breast, and no adenopathy; it is now fully 6 years since her first visit, and she remains perfectly well, and has given birth to still another living child. Many

instances of more recent cases could be reported up to the time of present writing, who almost invariably do well when absolutely faithful to treatment in every particular, so that if this can be secured one can almost promise those seen fairly early that they shall get well without recourse to the knife, x-ray, or radium which I never sanction, as I know too well from observation and experience are so unfortunate for the patient.

Naturally a good many advanced and post-operative cases are seen, and the curative effects of even the most careful internal treatment must not be judged by them. But one must not expect miracles, though the benefit even in the worst cases is often most gratifying. A few instances may be given.

Case VIII. Primary far advanced carcinoma of the right breast. Mrs. M. B. J., a widow, aged 68, with 4 children, was sent to me February 17, 1914. Two years previously she had noticed a lump in the upper part of the breast, after great and repeated mental distress, from the death of a number of near relatives, and a sister's mental derangement, the great nervous strain having been attended with various attacks and nervous indigestion. The mass increased steadily in size, but was kept concealed, even from her family, until the day before she called. Her family physician recognized that it was far beyond hope from any operation, in which view a prominent surgeon concurred, and sent her to me.

When first seen the whole breast was involved, double the size of the other, like a very large half melon, hard and immovable. There was a rather thick crust, several inches in diameter, adhering to an ulcerating surface, beneath which came a moderate discharge. The axillary glands were enormously enlarged, as also the supraclavicular, and she was strongly cachectic. To make a long story short, under very complete medical treatment, including painting the breast repeatedly with 50 per cent ichthyol in water, the discharge ceased shortly, with the crust undisturbed until she passed away peacefully from exhaustion of pulmonary œdema, on September 14, 1914. On August 4 it was recorded that the breast had done very well, was soft and movable and not larger than the other breast, with no discharge and no pain since a short time after beginning treat

ment. The axillary glands had diminished three-quarters in size and the supraclavicular glands were much smaller. She never took a particle of morphia nor any opiate.

The peace and comfort experienced by this lady during 7 months, with an enormous inoperable cancer and great cachexia, when first seen, was certainly very different from the generally conceived and observed course of cancer. If she could have undergone proper treatment a year or so earlier experience shows that the ultimate result would have been far different.

Case IX. Advanced primary ulcerative cancer of the left breast. Mrs. Dr. S., aged 85, was first seen September 16, 1918. After an attack of grip two years previously she noticed a small lump in the left breast which grew steadily and was treated with x-ray for over a year, and then with a radium tube 4 hours. There had been ulceration for several weeks. When first seen there was a mass 3 by 4 inches in the center of the breast, with a raw surface just above the nipple an inch in diameter, with a foul odor; there had been much shooting pain. She was placed on the "green card" diet, with the acetate of potassa and rumex mixture, and a calamine and zinc ointment. On December 29 her physician wrote that she had "gotten along remarkably well." While there was much discomfort and some pain, she was able to go about the house and do much knitting for the soldiers. There was later a good deal of sloughing, but the whole mass had a less angry appearance since starting treatment. She was fairly comfortable, without morphine or an opiate, until she collapsed suddenly in the bath room and died peacefully September 2, 1919, at 86 years of age. This case was also most satisfactory, as she lived nearly a year in reasonable comfort, about the home, and died rather from old age than from cancer.

It is not necessary to go into detail regarding many of the 30 post-operative cases which have been under treatment for they all have about the same sad story, but some of them are of peculiar interest on account of the good fight which was put up.

Case X. Post-operative carcinoma of the right breast. Mrs. B. E., aged 49, mother of 3 children, 13, 20, 21, was sent to