By H. PERCY DUNN, F.R.C.S.
THERE is reason for the frequent inquiry which meets the ears of medical men in the present day, Is it not true that cancer is increasing? For, however much we may attempt to throw into the shade our convictions upon this matter, the records of the Registrar-General remain to show, in all the obtrusiveness of an unvarnished statement, the annual increasing mortality from this terrible disease. A reference to the forty-third annual report of the Registrar-General discloses a somewhat alarming state of things, in connection with which it must be conceded that reflection affords but little assistance in the attempt to solve the cause. According to the report, 80,049 deaths from cancer occurred during the ten years from 1860-'69 inclusive, and the annual average increase was 248. During the years 1870-'79 the total number of deaths from cancer was 111,301, and the annual average increase was 320. As far, therefore, as numbers are capable of showing, we have here conclusive evidence of the increment in the mortality from cancer. It is observable also that the rate of increase is much higher in the latter than in the first ten years. It is, moreover, the case that the annual rate of increase is higher in the years 1860-'69 than in the preceding decennium—namely, in the years 1850-'59. In short, in the years 1850-'59 the increment was about 2,000; in 1860-'69, 2,400; in 1870-'79, 3,200. We have then confessedly to face the fact that cancer is increasing in our midst at a rate which bids fair to become more and more serious with the advance of time. In an article entitled "An Inquiry into the Causes of the Increase of Cancer," published in the "British Medical Journal" a year ago, I drew attention to the observations which had been made upon the subject by the late Charles Moore, whose investigations into the pathology of cancer had brought under his notice the incontrovertible evidence of the increase of the disease. In the year 1865 he published a small book called the "Antecedents of Cancer," the contents of which chiefly consist in an attempt to explain in what manner the augmentation of cancer is influenced by the circumstances of life prevailing in this country. For instance, he held that the introduction of corn laws, the discoveries of gold and sanitary improvements, whereby the well-being of the nation was conspicuously established, affected cancer indirectly by bringing into prominence the predisposing causes of its occurrence; and good living, it is thought, which follows as a corollary of commercial prosperity, is intimately associated with the manifestation of cancer. Again, inasmuch as cancer is characteristic of the healthy, it maybe expected to abound amid the conditions of health. The greater prevalence of the disease among the rich than among the poor can probably be explained in this manner. According to a French observer, the proportion of cancer in the wealthy classes is about 106