only malignant cases he saw among the Kafirs of South Africa in the seven years of his residence in that locality were six cases -all melano-sarcoma and all in the same location, the feet, but with metastases in the liver and lungs. The only other connective tissue tumors were the benign fibromata and lipomata. That he never saw an epithelial or endothelial malignancy during the entire time. The soles of the feet of the natives have deep cracks which become ulcerated, specially in dry weather, and the malignant trouble seems to result at the site of these cracks in the feet, indicating chronic irritation as the cause.

Coming now to the contemplation of our own American Indians, we can do no better than consider the table of figures from the United States Census Bureau given below.*

Figures from U. S. Bureau Census-Mortality statistics for 1921, 1922,

1923.

U. S.

1921......81.4

1922......83.0

Total Cancer Death Rate per 100,000 population in Registration Area,

1923......84.6 Total Cancer Death Rate Among Indian Population in Registration Area, U. S., per 1,000 Pop. 1922......19.2

1921......
......17.5

1923......22.5

It will, doubtless, be interesting to you as it was to me to note the conclusions drawn by an agency superintendent, long in service among the Indians, and who is well educated and keenly observant. He says, “Originally the Indians lived mostly on wild game and fish, with corn and dried berries, but, of course, as their conditions have changed, their diet has changed with *Figures from U. S. Bureau Census, 1923, Table from p. 16, Table R.

them. There has not been a greatly perceptible change in their diet during the twenty-two or twenty-three years I have been among them. Like the white man, they now live very largely from tin cans and paper bags. Either there has been an increase of cancer among the Indians during the time I have known them or I have been in a position to know more about health conditions during the latter years of my service than I was during the first. During the first years of my service, the scarcity of cancer among the Indians was a subject of comment. Now cases frequently come to my notice. I believe there has been an increase in the prevalence of the disease. Whether this is due to the change in their diet, I do not know. It is possible that it is due to the change in their living conditions. As you know, they originally lived a roaming, outdoor life and were compelled to hustle for sustenance. Now, a great many of them are inactive, loaf around the towns and their homes and grow fat on the revenue derived from their lands, oil wells, etc."

In the nearly twelve years which the writer of this article spent in Alaska during which he came into contact with many of the different tribes of the natives living there (although not all), he never found a true case of cancer among the full-bloods and but very few among those of mixed blood. The food of these people consists almost exclusively of fish and some shellfish, with cereals, berries and some vegetables and, as there are very few well-to-do among them, they prepare as nearly as possible the necessary amount for each meal and consume it in toto, and if their appetites are not then appeased, they supplement with dried or smoked fish.

From all the foregoing statements in this paper and from all the literature that can be found on the subject, the writer feels that the conclusions can safely be drawn that to civilization and all its influences may be attributed in a very large measure, at least, a decided bearing on the reasons for the increase in frequency of malignancy among primitive races. A simpler fashion of living, of eating, more and better systematized exercise, better elimination, and less stimulating food and drink, will in his opinion be of benefit not only to the white man but also to his more or less colored brothers.

CANCER A DISEASE OF EITHER ELECTION OR

IGNORANCE

By WILLIAM HOWARD HAY, M.D., Buffalo, N. Y.

Think back over the years of cancer research, of the millions spent, the time consumed, the pains expended, always with the local consideration of cancer only, and where are we today?

Is it not time to take stock of our basic conception of cancer to see if there is not something radically wrong with this, to account for the years of utter and complete failure to date?

Surely in all these years of lavish expenditure of time and money and effort we should have something tangible to show for our pains, though where are we now?

Cancer has been consistently on the increase ever since we knew it as a disease, and since the advent of the Society for the Control of Cancer, with its millions of endowed effort, this increase has been accelerating, till it begins to look as though a few more generations will see an end to civilization through this scourge of refined and soft living.

A study of the distribution of cancer among the races of the entire earth shows a cancer ratio in about the proportion to which civilized living predominates, so evidently something inhering in the habits of civilization is responsible for the difference in cancer incidence as compared with the uncivilized races and tribes.

Climate has nothing to do with this difference, as witness the fact that tribes living naturally will show a complete absence of cancer till mixture with more civilized man corrupts the naturalness of habit, and just as these habits conform to those of civilization even so does cancer begin to show its head.

Dr. Robert McCarrison records that among certain of the segregated tribes of East India, who are restricted by religion or custom to strictly natural foods in their natural form, he did not meet in nine years of residence, while doing post surgery for the British Government, one single case of cancer, except among the camp followers who were eating the British army ration.

He also records an absence of the usual digestive diseases which seem to be peculiar to civilization, not having encountered any case of colitis, appendicitis, gall-bladder disease, gastric or duodenal ulcer, constipation, diarrhoea, and ages there ranged so high that he doubted their system of vital statistics, till he verified these to his own satisfaction.

These people lived on the outgrowth of the ground in natural form, vegetables, grains, nuts, fruits, and on milk and milk products only. Is it possible the cause of cancer lies in our departure from natural foods? It would surely look so to any man from Mars, but we have so long lived largely on processed foods that are deficient in vitamines and tissue salts that we are in a state of unbalanced nutrition almost from birth, and with us birth and death are much closer together than among the simple peoples who live on the unprocessed fruits of the ground. And so we have come to regard our refined foods as the hallmark of civilization, when it is a fact that these very foods set the stage for every sort of ill, including cancer.

We recognize many forms today of what we call deficiency disease, but is not all disease an unbalancing of nutrition at base?

Sir Wm. Arbuthnot Lane of London, King's physician, chief of staff for long at Guy's Hospital, eminent in internal surgery among the world's great for many years, from his vast and ripe experience has decided that the great source of cancer in the human is the intestinal stasis from which nearly everyone suffers, whether recognized or not.

This great surgeon and really great man says: "I shall not die of cancer. I am taking measures to prevent it. What I am doing anyone can do. It is not a matter of money. It is a matter only of forethought and forbearance.

"What I am doing everyone should do if he would avoid the risk of death from a disease more terrible than syphilis, tuberculosis and a number of other awful diseases rolled into one."

"What I am doing anyone can do anyone should do." Do not forget that these are not the vaporings of a crazy enthusiast who is short on facts and long on theory, but of one of the most conservative as well as one of the most experienced of the great sur

geons of the world today, and there are but a few of these who can so qualify.

Now what is Sir Wm. Arbuthnot Lane doing that we can and should do to guarantee freedom from this awful scourge of civilization?

I will tell you just what he is doing, and then the ease with which anyone can do the same thing will be apparent.

He is using natural foods more, much more, and processed foods very much less in his daily eating. This is of first and very vast importance if we would escape not only cancer but the entire train of "civilized" diseases.

Secondly, he is making sure that the foods eaten today are all voided from the body tomorrow, escaping the fermentation and putrefaction of the usual food residues in the usual static and ptosic colon. He is doing this largely by the use of a bland mineral oil, as the ordinary rock oil that is so refined that it is not disagreeable to taste, taking this either in one large dose at bedtime, or else an hour before eating, better the former.

If the bowels do not move freely two or three times every day, they should be moved artificially, by means of the cool threequart enema before retiring, as it is most unsanitary to sleep with a colon full of decaying filth.

Till the correction of the eating habits has had time to activate the colon it is in the interest of better conditions to make this nightly enema a part of the toilette, and it is a very necessary precaution to see to it that there is enough water entering the colon to make sure this reaches every part, by either using three quarts all injected at one time, or else two quarts retained for two or three minutes, meanwhile lying on the back and massaging the abdomen, to make sure that the water enters every part of the colon. It is also good practice to use in this three quarts a heaping tablespoonful of some chemically pure bicarbonate of soda, to alkalinize the solution to near the body standard.

Raw fruits of all sorts, raw vegetable salads, stewed or baked or steamed vegetables, all of these, with milk, buttermilk, milk products that have escaped the usual sterilization or pasteurization, nuts, and perhaps a modicum of whole grain breads or cereals.