England has furnished more fully and for a longer period than any other country the mortality and dietary statistics of its population, and from these we can learn a great deal of value in our study.

According to a carefully prepared table by W. R. Williams showing the total population in England during the years from 1840 to 1905, cancer deaths had increased from 17.7 per 100,000 population in 1840 to 88.5 in 1905, or five times in numbers, and in 1913 there were 105.5 deaths from cancer in 100,000 population. During this time the meat consumption had more than doubled, to 130 pounds per capita in 1904; so that, according to Williams, it is estimated that among the adult well-to-do population the per capita meat consumption was from 180 to 330 pounds per year, in addition to large quantities of game, poultry, eggs, fish, etc.

The United States Report of the Meat Situation, 1916, also furnishes some valuable information to aid in this inquiry.

The Argentine Republic stands next in the consumption of meat, with 140 pounds per capita, and with a cancer mortality of 91 per 100,000 in 1900.

The United States comes next, with a per capita consumption of meat at 201.1 pounds in 1909 and a death rate from cancer of 73.8 per 100,000 in that year, which, as previously stated, was 79.4 in 1914 and 81.1 in 1915.

New Zealand exceeds the United States a little, with a meat consumption in 1902 of 212.5 pounds per capita, and an increase in cancer mortality from 32 in 1877–1888 to 60 per 100,000 in 1900 and 71 in 1903. This increase is mainly among British and other immigrants, whereas the aborigines, living simple lives, are seldom affected.

Australia stands first in the consumption of meat, with the enormous rate of 262.6 pounds per capita in 1902, and the increase of deaths from cancer there is most striking. In 1851 the death rate per 100,000 living was 14, in 1900, 62.6, and in 1913, 75 per 100,000 living. The most striking difference is exhibited between those who are native born, who in 1900 had a cancer death rate of only 22 per 100,000, while the British born had a mortality from cancer of 203, or nine times as great; a still higher ratio was found among immigrants of other nationalities. Those who have written there on the subject ascribe this proclivity to cancer to the gluttonous habits of immigrants, who have meat for breakfast, lunch, dinner, tea, and supper (MacDonald, Williams).

Italy, consuming the least quantity of meat, 46.5 pounds per capita, in 1901, has the lowest cancer death rate, but the present meat consumption cannot be learned. In Italy, however, the mortality from this disease is steadily rising, from 50.9 per 100,000 in 1860 to 1900 to 63.6 per 100,000 from 1906 to 1910.

But, as I have tried to show you all along, it is some derangement of metabolism which is at the bottom of neoplastic growths, and that derangement is not necessarily due to any one single cause, as diet. There are other elements of disturbance besides the nitrogenous malassimilation which is due to the intake of an excessive amount of the proteid of the animal kingdom; for cancer is said to have been seen in vegetarians, although I have never met with such a case. We know, however, that some or many articles from the vegetable kingdom, such as the pulses and some nuts, contain a very large proportion of proteid; thus dried peas contain 21 per cent, haricot beans 23, lentils 23.2, dried lima beans 26.4, soy bean flour, 39.5, butternuts 27.9, black walnuts 27.6, peanuts 25.8, and almonds 24 per cent of proteid, all more than is contained in beef and mutton. Thus a large supply of any of these might produce the same error in the blood stream as that induced by meat.

In my former lectures I pointed out also that coffee and alcohol were found by statistics and clinical experience to have a prejudicial effect on cancer, and therefore must be considered as elements in its production. In a later lecture I shall deal more specifically with these matters, in reference to the prophylaxis and treatment of the disease.