Section 23. See Also Appendix Viii., P. 362.

The meaning of this regulation would seem to be perfectly clear. There is no demand by the Government that the entire carcass of an animal affected by malignant disease shall be utterly destroyed for food purposes, unless the disease has involved the entire body,--a condition as rarely found among domesetic animals, as among human beings. Otherwise than this, what is there in the official regulations of the bureau governing meat inspection to prevent such use of the flesh of diseased animals as the inspector may authorize?

It seems to me that if science is ever to discover the cause of malignant disease, there should be a careful study of all the conditions under which the disease now manifests itself. The mortality from cancer in the state of New York, in 1912, amounted to 8,234; in England, the number of those who perished from the disease in 1911 was nearly 36,000. By what figure must we multiply this mortality in order to ascertain the number of persons living who have been affected, or who now are suffering from cancer? Nobody knows. What has been the success of surgery in securing immunity from a recurrence of the disease? So far as the entire country is concerned, we are entirely ignorant. Is it true that among the class of people in such cities as Chicago, where cancerous animals are used for food, cancer is especially prevalent year after year? If true, it should be fully known. Such facts must be ascertained, if ever we are to penetrate the secret of the dissease. Even the number of victims of each sex is not given in the mortality reports of the state of New York at the present day.

Let us suppose that the time comes, when with a realization of peril pertaining to ignorance, public sentiment shall urge the attainment of knowledge concerning cancer as it now affects the general population. In what way is information of this character to be secured? Assuredly not by any of the ordinary census methods, implying publicity. The only practicable enumeration would be one conducted privately, by members of the medical profession. Nor can it be done parsimoniously. In the state of New York, there may be, to-day, 50,000 cases of malignant disease. To have every case, completely reported, might cost the state half a million dollars. Perhaps even the patient should be compensated. Certainly some method could be adopted whereby the reports should be absolutely confidential, the patient being known only by a number. But all this is of minor consequence. When the necessity of the inquiry is everywhere recognized, the details pertaining to accomplishment will be easily arranged.

Assuming the willingness of patients and friends to assist in making a State-wide inquiry concerning the prevalence of malignant disease, let us see in what directions the investigation will be conducted.

FIRST. After securing the name, age, and place of birth of each individual sufferer, and the particulars which would suggest themselves to every physician or surgeon, inquiry should be made concerning the parents; the names, nationality, religious faith, place and date and cause of death. Especially should inquiry be made whether there have been other cases of cancer in the family, and their termination or present state.

SECOND. What is the location of the suspected ailment? When were the first symptoms manifested? To what cause, if any, were they ascribed? Has any surgical operation been performed, and if so, what are the details of time and place? Has recurrence followed operation? For what period was there freedom from symptoms?

Whatis the social position of the patient? Does he belong to that class which is enabled always to select the best food, the most sanitary dwellings, and all the conveniences of well-ordered and comfortable existence; or, on the other hand, to the extremely poor class, which disregards cleanliness, indulges to excess in the use of stimulants, and consumes the poorest and cheapest kinds of meat? I deem it of great importance that the completest possible information be secured concerning the usual diet of every sufferer from this disease. Is he a vegetarian? Are viands invariably well-cooked, or eaten sometimes rare or raw? Is there a liking for the canned products of the packing-house, or for sausage that comes from the same source? What is the water-supply? Within the knowledge of the patient or friends, has there been any other case of malignant disease in the same house? Is residence near any fresh-water lake or stream?

The relation between diseased meat and human ailments is treated at length in my work on "American Meat," New York, 1909.

These are suggestions only. They constitute merely an outline of the information that is necessary, concerning the living sufferers, in whom the disease has made its appearance. Doubtless the average reader will discern no reason for all these inquiiries. Yet each one has some pertinency to the possible discovery of the great secret. Does inquiry concerning family history seem useless? It should have a decided bearing on any theory of heredity. Does the occurrence of near-by cases have no significance? We are not yet in a position to state this as a fact. Does inquiry concerning religion seem especially impertinent? What if some future investigation should prove that cancer everywhere, is more prevalent among the Christians than the Jews? Does the social condition of the sufferer seem to have no relation to cause? What if we discover, that everywhere,--and not among the foreign population of Chicago only,--cancer finds an undue proportion of its victims among the poorest and most poverty-stricken element of every nationality? Does suggestion of inquiry concerning diet induce a smile? It should not, as long as meat derived from cancerous animals is permitted by Government authority, to pass inspection, and to be distributed throughout the world. And no inquiry concerning cancer can be deemed complete which has not fully investigated the extent to which this atrocious practice has been carried on for the past quarter of a century.

But this State-wide inquiry is only a part of the work. Every year, for a period of at least ten years, the record must be revised, the result of surgical operations recorded, the deaths enumerated, the new cases added. The expense of each annual revision would be far less than that of the original inquiry; but the inquiry will be costly, and should be costly, if it is to be accurate and complete. Here, indeed, would be the opportunity for the co-operation of organizations devoted to "cancer research," and particularly of that new foundation, the income of which for a single year is far more than the original investigation would cost.

And when the inquiry is completed; when all attainable information concerning the occurrence of malignant disease shall have been secured not for a single year, but for a period of successive years, not for one community, but for an entire state, and for each of its constitutuent parts, what then? Then I believe a knowledge of the cause of cancer will soon be attained. When we know the cause, then there will be hope for prevention, which is far better than cure. All the various experiments upon mice, for example, whatever they may teach concerning the disease in the lower animals, have not enlightened us concerning the cause of the malady in mankind. The greatest and most promising fields for scientific research, now almost untrodden, awaits the explorers of the future. In a world where now there is comparative unconcern, there may soon be fearful apprehensions of the increasing prevalence of an almost irremediable disease. Within the coming century, the investigation I have here outlined, will sometime be made; and, as a result, the cause of cancer may be as well known to medical science, as the causes of typhoid fever or malaria,--mysteries that seemed insoluble less than a century ago. And I venture with assurance to predict, that some time within the next fifty years, the Governments of England and of the United States, alarmed, it may be, by a continually increasing mortality from cancer, will condemn under severest penalties, the sale for human food of meat deriveed from animals affected by malignant disease,--no matter how great may be the pecuniary loss to every slaughtering establishment and packing-house in either land. The public awakening to danger that must precede legislation cannot yet be discerned; and before the national apprehension is aroused and apathy ceases, probably more than a million lives will be sacrificed to cancer, in England and America alone. ------------------------------ Note.--"The deaths ascribed to cancer or malignant disease in England and Wales during 1912, numbered 37,323. The mortality of males was 913 per million living, as compared with 891 in 1911, and that of females, 1,117, as compared with 1,098. IN THE CASE OF EACH SEX, THESE RATES ARE THE HIGHEST ON RECORD."--From 75th Report of Registrar-General, 1914, p. lxxxiii.