The rate in England is quite 50 per cent. higher than that of Italy. If we explain this by the hypothesis of greater skill in detecting the disease, what are we to say of the cancer-rate in Switzerland, which is 50 per cent. higher than that of England?
But here is another curious fact. The United States census of 1900 permits a contrast of the mortality of cancer according to the birthplaces of mothers of those attacked. Here, for instance, is the death-rate from cancer and tumour of persons of different nationality, calculated in three sections of the country—the rural districts of the registration area, the cities of the same section, and the cities outside the registration area.
DEATH-RATES IN THE UNITED STATES FROM CANCER AND TUMOUR PER 100,000 WHITE POPULATION, ACCORDING TO THE BIRTHPLACE OF THE MOTHERS OF PATIENTS
———————————————————————————————- | | | | | | Registration Area. | Other | | COUNTRIES. |———————————| Cities. | | | Rural | Cities. | | | | Districts. | | | |—————————————|——————|————-|—————-| | Italy .. .. .. | 20 | 24 | 39 | | Russia and Poland .. | 26 | 30 | 26 | | England and Wales .. | 79 | 77 | 80 | | Ireland .. .. | 90 | 82 | 86 | ———————————————————————————————-
How are these facts to be explained? What is there about the habits, the environment, the dietetic peculiarities of the Italians in America, which tends to confer upon them a greater immunity from cancer than is possessed by those whose maternal ancestry goes to England or Ireland? Assuredly this immunity is not due to chance. It is governed by some law, even though that law be unrecognized to-day. If the low cancer mortality of Italy made itself manifest only in that country, we might suspect it indicated a lack of skilled diagnosis; but here we find it just as prominent in three different section of the United States. Not only that, but the difference is seen in comparison of parts affected by cancer. For persons whose mothers were born in Ireland the death-rate in cancer of the stomach per million population was 184; the corresponding rate for Italians was 56.
Does the poverty of the people have anything to do with proclivity to cancer? In one way this is a probability. If we could compare the general prosperity of men and women whose parents were born in the United States with the entire population of which the parents were born in other countries, it seems to me that we should find the second class, taken as a whole, to be financially less prosperous than the first. Now, in 1900, the census reveals that in the United States the class to suffer chiefly from malignant diseasewas that which included THE FOREIGN-BORN POPULATION, alike in cities, in rural districts, within or without the registration area. This is certainly a fact of tremendous import. In America the population is a blend of every European nationality. Why, taken as a whole, should the native American suffer from one mysterious disease less than some of those who have come more recently to the United States?
In another work I have ventured to suggest that if we are to discover the cause of cancer, we must study the habits and customs of those still living who have become the victims of some form of this mysterious disease. A theory held by some is that cancer is due to the consumption of meat. If one means that the flesh of perfectly healthy animals is liable to cause cancer, the hypothesis is one for which it seems to me that the evidence is far from being sufficient to justify belief. But if, on the other hand, it is suggested that malignant disease may be due to germs derived from animals which were suffering from som form of cancer when they were killed for the food of human beings, then much that is otherwise obscure becomes plain. We should expect in such cases to find cancer more prevalent among the poor than among the rich, and especially prevalent among those who, from carelessness, or ignorance, or seeming necessity, consume the cheaper kinds of meat. And since, both in their native land and in America, the Italian population consumes less meat than peoples of other nationalities, we should expect them to be less liable to be infected by the germs of malignant disease.
A few years ago a medical writer who has given much attention to this disease published some of his investigations into the cancer death-rate of Chicago. Taking the figures for a single year, he discovered that the "cancer death-rate among the Irish and German residents of Chicago is the highest in the world, being nearly 300 per cent. higher than in their native countries."[1] Of each 10,000 population of each nationality living at the age of forty years and over, he found that the deaths from cancer among the Germans was 76, among the Irish 70, among the Scandinavians 52, and among the natives of Italy 24. It was found that, while the staple diet of Italians in Chicago was macaroni and spaghetti, the people of other nationalities among whom the cancer-rate was exceedingly high, "consume large quantities of canned and preserved meats and sausages, OFTEN EATEN UNCOOKED." He discovered that a large part of the fresh meat prepared at the establishment of a certain slaughtering establishment in Chicago was derived from animals which had been condemned on the ante- mortem inspection, but the flesh of which was perimitted TO BE SOLD AS PURE FOOD AFTER THE DISEASED PARTS HAD BEEN REMOVED. Sold thus at a cheaper price, such meat was chiefly consumed by the poorer classes of the foreign population. And while Dr. Adams does not adopt the hypothesis of the cancer-germ, he does not think there can be "the slightest question but that the increase in cancer among the foreign- born over the prevalence of that disease in their native countries is due to the increased consumption of animal foods, PARTICULARLY THOSE DERIVED FROM DISEASED ANIMALS."
[1] See article by Dr. G. Cooke Adams in Chicago Clinic of August, 1907, pp. 248-251.
A statement like this is calculated to induce serious reflections. The average reader finds it difficult to believe that, according to the present interpretation of the law, the flesh of animals found to be suffering from cancer at the time of their slaughter would be permitted to pass into the world's food-supply. We are int the presence of a great mystery. We do not know how the gret plague originates. But no reflecting man or woman can be insensible to the significance of possibilities when he learns that cancer affects animals which are killed for food; that in the majority of cases the disease affects some part of the digestive tract; that it chiefly prevails among the very poorest classes of the population, excepting only those like Italians, who use but little meat; and that, according to the official regulations of the United States Government in force to-day, THE FLESH DERIVED FROM CANCEROUS ANIMALS NEED NOT ALWAYS BE DESTROYED AS UNFIT FOR HUMAN CONSUMPTION. The cancerous tumour, the affected parts, must indeed be cut away, and carefully condemned. The disposition of the remainder of the meat is left to the decision of the inspector!