without pain. In all my long practice with many hundred cases, I can hardly remember half a dozen in which I have resorted to an opiate, which only increases the disease.

In speaking of the vegetable extract soup, I forgot to mention some points which are of great practical importance in the medical treatment of cancer. Travellers have mentioned that in several regions certain tribes drink all the water in which the vegetables are boiled, and cancer is unknown. This led me, some years ago, to devise a plan of a pure vegetable soup, which I have had made for years in different classes of society, from the poor in tenement houses to the rich elsewhere, and have had it well done, and regard it as about the most important element in the treatment of the dire disease; I will briefly explain.

An agate lined (not aluminum) vessel, covered with a cloth is kept on the stove all the time. All the water in which the family vegetables are boiled, separately, is poured into this pot each day, even for weeks, so that the juices of a dozen or more vegetables may be used. If potatoes are peeled the peelings are boiled with the potatoes and taken out and mashed, and are put into half pint or more of the vegetables extract in a sauce pan, for the noon meal soup. This is then thickened with graham or whole wheat flour, rubbed up with butter, with three tablespoonfuls of well cooked rice, and some ground up cooked vegetables, cooked macaroni or spaghetti, tapioca, sago, with flavoring to suit, more onions, celery, tomatoes, to make a thick soup the main component of dinner, with plenty of graham or whole wheat bread and butter, and water, or more of the vegetable extract drink. Of course, no meat or meat stock is to be used. This vegetable soup on the stove is liable to get sour, unless it is poured out daily, the vessel scalded and scoured, and the extract poured back. All this is done to obtain the combination of the salts and vegetable proteins from as many vegetables as possible, which secures the best pabulum to enable the cancer cells to return to normal. I believe that I mentioned that of late years, I have had the clear vegetable extract from the central vessel drank, two cups hot, with the

evening meal, instead of tea, thus obtaining a larger amount of this nourishment. The rationale of all this is that the vege tables contain a large amount of the potash salts, for the acetate, carbonate, and phosphate of potash are the main medical sheet-anchors in the medical treatment of cancer, which has yielded such brilliant results.

In reviewing all this, and much more could be said, we see that it is no light matter to undertake and carry out successfully the medical treatment of cancer, and that it is quite a different proposition than a brief surgical removal of some diseased tissue, which is so commonly followed by a recurrence, or fatal metastases. These latter have been fully considered in the last chapter in my forthcoming book, and need only to be mentioned here. The more we study x-ray plates of cancer cases, the more we see how often we find evidence of metastases in the deeper tissues, lungs, liver, stomach, pancreas, bones, etc. We see thus that cancer is no trifling local disease to be attacked by surgery, x-rays, radium, injections of serum, colloids, etc., but one of systemic or constitutional nature, the result of long wrong living in many directions. We realize why the first mentioned points were made of the need of patience, perseverance, medical acumen, pluck, and hopefulness, with wide wisdom and experience in general medicine are necessary to carry out successfully the medical treatment of cancer. But the experience of many all over the world have shown that this can certainly be done, if they are applied long, intelligently, and earnestly enough.

DEATH FROM BLAIR BELL'S COLLOID LEAD

INJECTION

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

Mrs. H. J., aged 49, weight 118, with a normal weight of 143, came to me on June 24, 1926, with the following history: In July last she began to have pain in the region of the rectum. She had had prolapsus of the uterus for some years, and a tear with the first and last child, some years ago. She saw a

gynecological surgeon, and went to Buffalo in August and September, where she was given several quarts of cold enema, and again in Buffalo in January. She then saw her Pittsburgh gynecologist who discovered lumps by the ovary, and then went to Florida for two months. During this time she fasted for three weeks and had lived largely on vegetables and fruit. She had always been constipated and took a daily enema. The urine had been troublesome, several times at night.

On examination, abdominal palpation revealed a large mass moving with the uterus, the cervix being ulcerated; the right inguinal gland was the size of an egg, and the uterine tumor infiltrating the anterior wall of the rectum, and the posterior wall of the bladder. The skin over the enlarged gland was burned by electric current or heat, by one of her doctors, etc.

I saw her only three times, and realizing the serious character of her disease, I put her at once on a very thorough treatment, dietary, hygienic, medicinal, and a local vaginal douche of carbolic acid and soda bi-borate, and hoped that in the end the trouble would yield, as it had in many other similar cases, to prolonged and careful medical treatment.

I have learned from my late assistant that she or her husband wanted the Blair Bell lead colloidal treatment. As I could not endorse this, he went on to a distant city, making several trips, giving, as I learned, increasing dosage of the lead, until, on his sixth trip he found that she had died that morning at 7 o'clock, August 17, 1924, about four weeks after beginning the treatment. She would probably have lived many months, and possibly have gotten well, had it not been for the unfortunate employment of the colloid lead, which I neither endorsed, nor even sanctioned, as I was not consulted about it. I note in Dr. Bell's Article in the Lancet, that only 10 out of 227 cases on whom it was tried were reported as well, whereas two or three times as many died.

Another Martyr to the Roentgen Rays.-The recent death of Dr. L. F. Hall Edwards, the review of whose recent text book appears elsewhere, adds another name to the list of martyrs to the Roentgen Rays. He published "Surgical Radiology" in 1896, and "Radiography" in 1897, and was incessantly devoted to radiological work, for many years, receiving the Queen's medal with four clasps. From 1901 he suffered so severely from roentgen ray burns that after six years of constant pain he consented to the amputation of his left arm, and the removal of the greater part of his right hand.

Professor John George Adami, whose name was prominent in connection with pathology and cancer, especially when he was professor at McGill University in Montreal, from the time he was 30 years of age, until he went to the great war with the Canadian Contingent, and later became Vice Chancellor of the University of Liverpool. He was indeed an illustrious pathologist, and contributed much to the knowledge of the pathology of cancer, and his death is a great loss to science.

Dr. William Francis Campbell, of Brooklyn, a well known surgeon, in connection with cancer, died September 17th, 1926, after an operation for cancer of the stomach, in one of the New York Hospitals. In a recent conversation with him he seemed to accede to the uselessness of surgical operation on cancer, and we believed that he would soon be a convert to the constitutional nature and treatment of cancer.

Dr. J. Lyman Bulkley, late of Nebraska, has recently joined the Editorial staff of CANCER and will be its Associate Editor. Unusual circumstances have unavoidably delayed the October issue, for which we apologize, and hope it will not occur again.

Referring to the report of the recent Report of the Mohonk Conference on Cancer elsewhere in this issue, which was made largely from the daily newspapers, it may be interesting to read what the manager of the whole affair has to say regarding their accuracy and value.

Is Betel Chewers' Cancer A Tobacco Cancer?-Krishna Iyer, writing from Bellary to the Indian Medical Gazette for April, 1926, takes issue with the statement that the betel leaf, areca nut and the lime chewed with it plays the major role in betel chewers' cancer. Many who chew betel, but abstain from tobacco, never develop buccal cancer while conversely many who use tobacco but not betel leaf do develop the latter. In Malabar, where tobacco is added to the chew, cancer is common; in the Tamil region where little tobacco is added, it is rare. Brahmans who chew betel seldom develop cancer, and they are mostly abstainers from tobacco. The chuman or lime may play a minor role.

BOOK REVIEWS

MALIGNANCY AND EVOLUTION, A BIOLOGICAL INQUIRY INTO THE NATURE AND CAUSES OF CANCER. By Morley Roberts; London, Eyeleight Nash and Grayson, 1926.

This large, octavo book of 319 octavo pages, written by a layman, is certainly a marvelous work, and represents vast labor along medical lines, for a man who is primarily a philosopher and a logician. He attempts to show that cancer is the direct product of evolution, whatever one may think of Darwinism as an established fact. But to our mind he does not establish clearly or certainly that malignancy is one of the stages of evolution, if that is true. He wanders off into many side issues, and continually refers to sociological developments to illustrate the changes which take place in the formation of cancer masses.

However, he often refers to environment and nutrition as elements in the production of cancer, and after reading this book, I feel sure that Mr. Roberts will before long come to recognize cancer as a systemic disease, due to erroneous living, as he already recognizes it as a disease of civilization. He devotes some pages to arguments against a parasitic origin of cancer, including a criticism of the claims aroused by the work of Gye and Barnard. What the practical value of attempting to associate malignancy and evolution is, is difficult to understand. We all recognize the development of the human race, and the advance in knowledge and invention as a progressive development of mankind, call it evolution if you please, but not from an ape.

CANCER, ITS CONTROL AND PREVENTION; EDUCATION WILL LOWER THE DEATH-RATE. By John F. Hall-Edwards, Major late R.H.M.C., L.R.C.P., L.M., (Edinburgh), etc.

In striking contrast to the book just reviewed, is this small volume of 88 pages, by a Major formerly in the Army, with many medical titles, and a member of many Societies and for