HEALTH COLUMN.

Otago Witness, Issue 2456, 17 April 1901, Page 62

HEALTH COLUMN.

The Causal ion of Cancer. (By Sir James Sawyer, M D., F.R.C.P., Lond.) Like Sir William Banks, whose admirable lecture (the Lancet, March 10, 1900) 1 have read with much interest and instiuction, I h.>ve been in practice about a third of a century, and, as he has done, I 'have been led to form some decided "impressions ' as to the etiology of cancer in our midst, he forming his ideas from a surgical standpoint and I from a medical one. While statisticians, clinicians, microscopists and medical geographers are continuing their good work in adding to our knowledge of the incidence and pathology of cancer, and while we are not quite without increasing knowledge even of its successful therapeutics, and while we await the full light which research and observation w ill assuredly .shed some day to make plain the causes and cure of cancer, in the meanwhile the impressions of thoughtful practitioneis are of the gieatest value as working hypotheses in preventive piactice. The probability of the truth of such impressions is strengthened when it is found that many minds arrive at the same conclusion*. I have long thought that the accepted increase of cancer in England in recent years is due to the increased feeding of the population, and especially to increased feeding upon meat. It appeais from the leports of the Registrar general that the mortality fiom cancer in England and Wales has almost exactly doubled during the 31 years immediately preceding the year 1895. It also appears — as stated by Sir William Banks in his quotation from the summary of the figures of Mr Haviland — that the increase in cancer mortality amongst us has arisen more amongst males than amongst females. If we desire to reason by the method of concurrent variations on the causation of cancer, we shall be led to inquire as to what great and widely-spread change has happened in the habits of life of the population of England and Wales during the last 30 years or so, and the fact of the enormously increased consumption of meat by the great masses of the peqple will be forced upon our attention. This generally increased consumption of meat has followed the continued importation of huge quantities of more or le^s fre-h meat fiom America, and from tihe antipodes. I do not mean that vegetarian feedeit — if there be any who aie strictly Ftich — ?,seape cancer. The intinnte cause of cancer we do not yet know, but the mainly has many of the features of a locol overgrowth of tissue elpmtnts, and such appears to bs favoured by excessive feeding, and especially by feeding exces-ively and for a. long time upon meat. In my expenence cancer has not mci eased * of recent yenis amongst the upper middle cla^ssp. In that class the general tendency seems to be towards refinement and vaiiety of food, with the consumption of le^s meat, and with slower and more comjjlete cooking of meat, than foimeily ; but for the men of the "masses ' of our people meat is more a prevalent lood than before, and with them meat is eaten in single di«lie% in relatively large quantities, often, and undercooked. I "think it likely it will be found that it is amongst the men of the masses in England and Wales that the progressive increase in cancer in the penod under consideration ib mainly to be found. Steam appears to have brought us cheap food, and cheap food has multiplied our cases of cancel by two.

Bleeding from the Lungs. — Bleeding from the lungs i% one of the not uncommon symptoms of consumption, occurring at some time in the com«e of the disease in perhaps two-thirds of the cj&e«. It is often the rirsb indication of lung trouble in a person who lias been losing flesh and growing weak without any pppaient cause, but it more often occurs in advanced stages of the disei^e There may be one hemorrhage only, oi tin trouble may recur frequently ; *uA ibs aia.pu.ut of blood expectorated may

be barely enough to tinge the phlegm, or the bleeding may be most profuse — a cupful or even a pint or more. It very rarely happens that the quantity is so great as to endanger bfe. yet the blood may be poured into tihe bionchial tubes more rapidly than, it can be coughed up, and so actually diown the suffeicr. The neatment of hernoirhag© oi the lungb con c ists first of all in rbsoluta quiet. The patient should be m a cool room, lying down, but .with •'houldeis raised, and should be foi bidden to talk. Swallowing cracked ice may be serviceable, and also cold applications to the che-t; but, of coui?e, a physician must be called to administer suitable remedies for the control of the bleeding if it is at all profuse. Quiet, deep breathing is useful, but the patient should avoid any attempt to keep back the blood, for when it has once escaped from the biooJ-vessels it is better coughed up than remaining in the air-tubss. Fear or excitement only makes the bleeding worse, and patients should be taught th?,fc the hemorrhage is a usual occurrence in consumption, and that it seldom has any effect upon the course of the disease ; especially that it doss not at all preclude absolute recovery under proper hygienic treatment. Some physicians tell consunip* tive patients that they must expect one or more attacks of hemoirhage, possibly quite severe ones, but that such hemorrhage is usually of no great moment. In some cases, indeed, when the spitting of blood is due to congestion rather than to an actual tear of some of the blood-vessels, it may be beneficial, as tending to relieve the stagnation, and so give the circulation a chance, to re-establish itself. An impoitant fact to lemembsr, one which may tend to relieve the sufferei's anxiety, is that the blood winch is expectorated is much moie uftcn from the throat or nose than from the lungs, and may have nothing to do w,tl» the fact that the pitient is a consumptive.

Overcrowding and Consumption — Among the many points upon which light i-J thrown by the interesting annual repoit issued by Mr Sihirley Murphy, medical officer to the county of London, one of the most important (says the Hospital) is that of tjie relation between mortality, and more especially mortality from phthisis and overcrowding. By a series of diagram^ he shows, in the first instance, how steadily the mortality rises in jJi-oportion to the degree in which overcrowding prevails. But this lise is nothing to what occurs in regard to phthisis, for it is shown, that with the higher degree* of overcrowding the accompanying increase ir the death rate from phthisis i.s 'proportionately more than twice as great as that in the death rate from all other causes. It is true that phthisis is most common among the poor ; it is true, also that phthisis leads to poverty ; and, again, that, however poverty arises, overcrowding is its common and almost necessary accompaniment. Thus the problem is a complicated one. Nevertheless the disproportionate degree to which the death rate from phthisis is raised among those 'who pass their lives in overcrowded dwellings is so striking that it seems impossible to avoid the conclusion that if we could but leiscn the overcrowding we should cut at the root of one of the most potent causes of consumption. Whatever may be the intricacy of the problem, we cannot permit oui selves to be content with a state of affairs which results in the phthisis death rate in some districts being nore than four times as high (per 10C0 living) as it is in other more favoured portions of the metropolis. It must be remembeied that even the contrast between the different groups of distiicts set out in Mr Shirley Murphy's report, striking a-s it is, does not express the w-hole truth. The death rate of each district is but an average. In some parts of each both the death rate and the overcrowding rate must be higher, and in other* lower, than the rest. Thus in those districts, such as Hampstead, in which the phthisis mortality is the low-est, no doubt there are areas in which it is far lower than the figuies tell us; while in Southwark and St. Luke, where it is the highest, one may be perfectly certain that the average phthisis mortality for the whole district, high as it is, does not in any way express the decimation of the population which is going on in some of the most densely populated areas. We may express the belief that if in the collection of statistics in regard to consumption il v;cre possible to group together, not whole sanitary districts, but sepaiate streets, classified according to overciow ding, much as was done in Mr Charles Booth's gieat v. oik in aocrrdance with social condition, we should find revealed a state of affairs which would force the hands of our refoimers, and drive them to adopt measures to oppn out the gieat city of London and spread it over a far wider aiea than it covers at the present time.

"I cannot fcnfficiently express my thankfulness to jou for having invented Tussic_tTr.\; it ij» vroith its weight in gold!" 'J hese words are taken from one of the innumerable testimonials that have beon tpcehed in legard to this mixture, and this opinion is unnersdl among these who have tucd it. The preparation has had to overcome many prejudices, and the success ifc has attained is therefoie all the more gratifying. No better proof of itt Genuineness could be gnen than the fact that, m spire of the number of cough cures in the market, Tussicun-v has forced its way to the front, and no more popular remedy for throat and lung complaints exists at the present time. Tins popularity is undoubtedly due to its own intrinsic merits, for no amount of "puffing" will induce the public to purchase an aiticle, unless experience has proved it to be good. For bronchitis, pleurisy, and all pulmonary complaints, it cpnnot be surpassed, while it has been invariably effectual in cases of influenza. With, such a record in its favour, there is no reason to be surprised that TrssiCUß\ has pio\cd so successful, and wherever it hn9 found its way into a household it has been/ recognised as a sovereign remedy. Tho preparation has withstood the test of time and experience, and its merits only require to become more widely known to ensure a moie extended sphere of usefulness in tho future.

— Moie than a million people are treated ia the liosjgit^ls oi London each year.