The representative. [volume] (St. Paul, Minn.) 1893-1901, 1899-05-11

"A FURTHER STUDY INTO ITS FIRE.
QUENCE AND NATURE.
Roswell Park, M. d., of Buffalo, N. T.,
Professor of Surgery I'm the Medical
Department of the University Of
Buffalo, Describes 1t ~ Parasitic,
NOn-Hereditable, Perhaps COnta-
giOus and Certainly Increasing.

The object Of this paper is threefold:
First. to emphasize the ever increasing NOR
tally rate in this state from cancer; sec
ondly, to epitomize some of the more recent
studies in regard to its etiology, and espe-
tally the arguments which point more and
more towards its parasitic origin; thirdly.
to bring 20 your notice the work already
Gone and in prospect in the new laboratory
started under the auspices of this state and
located in Buffalo.
With regard to the increasing mortality
rate, 1t would consume too much OF your
time L were to read tables which have
been carefully prepared from the returns OF
tine state board of health, but the principal
facts brought out can be briefly laid before
you.
These tables show with regard to another
disease whose cause used to be equally I'M
known that since the discovery of the Pc
culiar organism to which it Is due Its NOR
tality rate has steadily declined. l allude,
OF course, to consumption. Since its cause
has been Known intelligent and properly
directed efforts have produced very mark
cd decrease in it's ravages. On the other
hand, the death rate from cancer is steadily
increasing, not alone in New York state,
but apparently in all parts of the world.
that This increase will undoubtedly continue
until its minute causes are positively deter
mined.
So far as we have been able to learn,
cancer is now the only disease which is
steadily upon the increase. In England and
Wales, for instance, where most careful sta
tistics are kept, the cancer death rate has
risen from in 5,646 of population in 1910 to
] in every 1906 Of population in 1896; that
is. in 90 years the proportion has increased
nearly five times All over this country the
increase is quite as alarming, while the
figures pertaining especially to our own
state are equally significant and quite in
compatible with its increase in population.
Thus. for instance, in 1887 there were in
this state 2 1863 deaths from cancer and IL 500
from consumption. In 1898 there we're 4456
deaths from cancer and only 1852 from
consumption. This increase In cancer NOR
tally is certainly not due to improvements
In methods Of diagnosis but rather the re-
verse is the case, since many cases which
were formerly diagnosed as cancer are now
properly classified where they belong in
other lists. In none of the other diseases
iabulated by the state board of health. nor
III any government reports, has there been
such an immense increase as in cancer. 1t
is the only disease tabulated which shows
progressive and steady increment by
months and by years.
careful study of all these tables per-
mts one to make the following startling
prophecy: If during the next 10 years the
relative death rates are maintained we shall
fEd that 10 years from now, viz, in 1909,
there will be. more deaths in New York
state from cancer than from consumption,
smallpox and typhoid fever combined.
1t is most interesting again, to see how
cancer is particularly prevalent in certain
regions. There is recent report by DR..
Symons, medical officer of Bath, England,
who has found that in his territory cancer is
so per cent more frequent than in neighbor
ing localities. But the most extraordinary
and significant Typographical and statistical
study of recent times is that of Bella, in
the concluding numbers of the Centralbatt
fur Bakteriologie for $685. which pertains
to the little town of Luckan, in Germany,
where within the past % years there have
been Is deaths from cancer in an area COW
cred by two or three city squares, as many
as four deaths from 1t occurring in one
house. and where the disease has assumed
the proportions and the Importance of an
epidemic. To this paper should be given
the careful consideration of all who are in
tcrested in this study, though to be sure,
similar epidemic appearances OF the disease
have been noted in other parts of the world.
and in milder form may be said to have al
most prevailed in times past in certain
localities in Western New York, where the
disease is exceptionally prevalent. Prob
ably it is not necessary to do more than to
rehearse these very brief facts in order to
bring wildly to your minds this great and
increasing source of danger to our pOpula
ton.
1t is possible to sweep aside. with one or
two possible exceptions, everything that has
been brought forward until within recent
years as an explanation Of this disease. The
old theories of irritation. Of perverted nerve
centers, CT heredity, etc, cannot for mo-
ment stand in view of the searching scien-
tific methods of today We have gotten as
far as this at present that we know that
cells act as they do in producing the disease
either as the result of some external or in
ternal stimulus. The exact character Of this
stimulus is not yet certainly demonstrated
though things point more and more toward
its parasitic: i. e., its potent living, in
fuence.
There are so many analogies between can
Ger and other diseases which are known to
be infectious that these alone should be
enough of themselves to almost convict,
aside from the ordinary revelations of the
microscope and the findings of the expert
mental laboratory. If cancer be an infec-
ton it must be acknowledged that, as rule.
it is exceedingly slow This, however, does
not prevent us from accepting such diseases
as syphilis. leprosy, and others as in their
essential nature parasitic. We know very
we'll that infections vary within the widest
limits in their intensity and rapidity of
action from those which kill within few
hours, such as yellow fever, cholera and the
like, to these in which two or three weeks
are required. like typhoid fever, or those
which ordinarily are much slower yet, like
tuberculosis. No valid argument, therefore,
can be made against the infectious nature
of cancer based simply on the time limit.
We know now that tuberculosis is not in
herited. though the predisposition to it may
be, and we believe the same thing to be true
of cancer. But anything which points to
direct incubation from one individual to
another is of incontestable value, whether
recently observed or a thousand years ago.
Further analogy Is found in the undoubted
cachexia of it's later stages, or let us say the
more pronounced stages, of all the infections
Such toxic conditions we rarely get from any
conditions save the genuine infections. The
supposed intimate relation which injury
bears to cancer is of no more Importance
than that upon which the clinicians, and
even the Psychologists, used to place so
much stress in tuberculosis. There are still
those who claim that the predisposing cause
OF most tubercular joint LESSONS is previous
injury of some character, and there are still
those who look for a similar mechanical
cause OF cancer in virtually every case
What is there about injury which, by itself.
can produce at one time tuberculosis. at an
other syphilitic gumma, or at vet another
cancer. save that either at the moment II
has permitted a surface or deep infection or
that directly 1t has so far changed the vul-
nerability of the tissues as to permit Of their
more easy subsection to minute enemies
from without? Trauma, therefore. must he
disregardcd save as it plays a suhsidiarv
role.
Tho occurronce of cancor In oo....