Cancer Research.

CANCER RESEARCH.

employe of the institution. The Birmingham Hospital Saturday Fund, the

failure of the

scheme,

last

in

report

of the

admitting

states that the claims of the

the more

1195

on such a basis was necessary if their support was to be retained. The general character of the scheme is certainly comprehensive. According to its terms any worker whose efforts are, however indirectly, tending towards the elucidation of problems bearing upon the nature of cancer may fairly consider himself a just claimant for It is here that our main concern lies for the best of the fund. Not only the right paths of utilisation possible work must be trodden : they must be trodden by the right men. Whether the mystery which obscures the nature of malignant disease is in the near future dispelled or not, a great work will be done for the cause of true scientific progress in England if the raising of this fund starts a class of trained scientific medical workers methodically, collectively, and uninterruptedly pursuing investigations with time and thought unfettered by other ties. The English medical schools no less than their continental The analogues breed keen and capable investigators. in this find science a however, country majority, glorious Unless he is excepmistress but a poor paymaster. tionally fortunate the young man of science who has had medical training is obliged, whatever may be his natural talents or inclinations, to desert the narrow paths of research for the at least more productive field of practice. In plain

self-respecting members of the community to obtain consulting advice at a fee of half-a-guinea rather than be forced to obtain it at the hospitals for nothing have been set at nought." This, of course, is a misleading way of speaking. What has happened is that the said thrifty and support. self-respecting persons will now obtain from men of real experience and learning the advice which the Birmingham Consultative Institution never could have given them by a system of consultant medical officers possessing We are no opportunities of gaining clinical experience. the Fund has that Birmingham Hospital Saturday glad taken the sensible step of ceasing to attempt to oppose the main principles of medical practice. The attempt to exploit the medical profession was an unworthy one. The belief that a young man, attracted by a salary and adorned with the label of "consultant," became capable of giving superior medical advice was ridiculous. Moreover, the statement that the institution was required to meet the wants of a particular class, neither rich enough to consult the usual physicians or surgeons nor poor enough to seek the hospital, was untrue. No such want existed, for the medical profession in Birmingham had with practical unanimity offered to meet it. How they are now meeting it will be seen at words, he cannot afford to remain a purely scientific once by perusal of the correspondence forwarded to us this observer and investigator; only if of exceptional energy week by Dr. SAUNDBY (see p. 1209), whose vigour and energy or particularly favoured by circumstances can he continue throughout the struggle have been worthy of all commenda- scientific investigations at all, while his main efforts are tion. He had a good cause to champion and an obvious perforce directed towards gaining a livelihood from the abuse to eradicate. He has succeeded all along the line and practice of his profession in one or another of its we have been glad to help him. If the scheme for the organised investigabranches, thrifty

and

"

tion

Cancer Research. IN a leading article last week we commented upon the scheme put forward by the Royal College of Physicians of London and the Royal College of Surgeons of England for the organised investigation of cancer. For the working of this scheme

of

is

to be

£100,000 judged day that our article was published daily press an influentially signed appeal to the public to subscribe this money. Already onefifth of the amount has been paid or promised and it is sincerely to be hoped that the remainder will be forthc )ming quickly. In our remarks upon the scheme, which was published in full in THE LANCET of April 19th, p. 1131, we touched upon the apparent superfluity of the general committee, and one at least of our lay contemporaries was struck equally with what appeared to be an unnecessary clumsiness in the working machinery of the scheme. An explanation of the constitution of this body has been given to us since. It had originally been hoped that all the money would have been supplied by one individual or at all events by a few contributors. That hope was disappointed and so, the general public being appealed to, it a

capital

sum

neces-

sary and on the same there appeared in the

thought wiser

to include in the

arrangement of the constituted as to represent the wide area from which it is hoped that the funds will be drawn. In fact, the most influential patrons of the scheme signified their view that a general committee formed was

scheme

a

controlling body

so

of

cancer

removes

these

disabilities

from

the

class of man to whom we have referred the medical profession and the country at large will owe it a heavy debt of gratitude. It was our fear lest the constitution of the

general committee should hamper rather genuine worker that led us to criticise view of what

we

that the

hope investigators a

than encourage the its formation. In

have heard since it is sufficient to express great difficulty of the proper selection of

will be surmounted.

It is here that

we

trust

that the executive committee will not too narrowly limit its awards to those only who seem to be working directly at the subject of cancer. Utterly unknown as is the cause, and

largely speculative as are all the theories as to the nature, of malignant growths, an infinite variety of special lines of investigation may rightly be claimed as leading truly towards It may prove true that the wisest way the desired goal. of attacking the question of complicated malignant tumours is to study the simplest forms of growth first and not

cancer.

endeavour at once to unravel the secret of When the growth of simpler tumours, the occurrence of hypertrophies of various tissues, the proliferation of embryonic cells, the very development of the ovum itselfto

when these phenomena and allied manifestations in the vegetable world are understood and explained to the minutest chemical and biological detail-perhaps then for the first time shall we be in a position hopefully to assail the fortress which at present hides the secret of malignant. growth securely from all our efforts. In

one

particular,

at

least, such

a

scheme

as

that put.

REVISED CLASSIFICATION OF CAUSES OF DEATH IN NATIONAL

1196

RECORDS.

by the Royal Colleges is certain to produce bene- may still be maintained in a class of statistics which are tficial results. It will surely result in a saving of labour by rapidly becoming of great national importance. We much ,the increased inter-communication among men working at the regret that other urgent demands on our space preclude our the new official list in our present issue, but we same or allied subjects. Isolation in scientific work almost publishing to insert a complete copy in THE LANCET of next hope inevitably means that much unnecessary work is done week, together with a set of appropriate suggestions for its "over ground that has already been thoroughly tilled use, which we are confident will be utilised by our readers another whose labour has not come to light. The in filling up their certificates of cause of death. by - forward

of statistics and other classifying work that will be done under the scheme should prove a great boon in providing individual workers with a wide view of what The general ’has already been thoroughly accomplished. standard of knowledge, too, concerning all subjects bearing

’collecting

upon cancer the medical ’Good results

should

be

raised

both

in

the

ranks

of

profession and among the general public. these, whether or not they include ’’the consummation devoutly to be wished for," and we hope that it "will not be long before the rich and generous provide, if at any rate such a proportion of it as will enable many a true student to devote himself to .scientific work the doors of which are at present closed not the entire

;E 100,000,

- to him for lack of the

golden key.

Annotations. " Ne quid nimis."

REVISED CLASSIFICATION OF CAUSES OF DEATH IN THE NATIONAL RECORDS.

THE CORONATION AND THE POOR. THE Local Government Board has issued a circular to the Poor-lawauthorities of England and Wales, and also a circular to county councils, councils of boroughs and urban districts (whose accounts are subjected to audit), rural district councils, and parish councils. These circulars direct that such Poor-law authorities or councils may make various modifications in the diet and discipline of the poor persons in workhouses, or that any reasonable expenses may be incurred by the councils in connexion with the public The councils, however, celebration of the Coronation. must be cautious-at least, we take that to be the meaning of the following somewhat cryptic sentences : " The effect of the sanction will not be to legalise any expenses in this matter. It will only prevent the disallowance of such expenses, if reasonable, by the district auditor at the audit." However, it is quite plain that the Local Government Board intends that the poor and needy shall have not merely a sentimental interest in the Coronation. It is of but little use to tell a hungry man to rejoice ; let us hope that on the two great days of the Coronation and the day after it mirth and good cheer will abound from one end of the kingdom to the other. ____

THE

PECULIAR

PEOPLE AGAIN.

ONCE more the death of a child has been brought home WE are indebted to the Registrar-General for a copy of .the new official list of causes of death which was adopted at to parents belonging to the sect known as the Peculiar Somerset House at the beginning of the present century for People and light sentences of a few months’ imprisonment have .the abstraction of deaths in England and Wales in place of again marked the difficulty of dealing with these unhappy the previous list which, in all essentials, had been in use at fanatics. We have written of them in these columns the General Register Office ever since its foundation in until we almost owe our readers an apology for again The new list is based on the nomenclature of referring to the subject. Everyone knows that the Peculiar 1837. - diseases authorised by the Royal College of Physicians People take literally an isolated passage in the Bible In and neglect all those which refer to the beneficence of of London and contains several important changes. the first place, the old classification of diseases has been medicine and the necessity for the exercise of the physician’s - considerably modified. Thus the time-honoured titles skill, with the result that when one of their sect falls ill an "zymotic," "miasmatic," "constitutional," "develop- elder is called in who anoints with oil and prays, while the mental," and "dietetic," have been discarded and the patient dies or lives as nature may direct. When this important series of diseases hitherto classed under one or happens in the case of an adult nothing can be said, or at - other of these names has been placed together under the any rate nothing can be done ; but certain Acts of Parliament comprehensive heading"General Diseases(Morbi corporis have cast the obligation of providing medical attendance for universi). In the grouping of these general diseases several children upon parents and others entrusted with the care of improvements will be found. Thus the important class of them, and the neglect of this obligation, if it causes the death malignant diseases has now been subdivided into (1) of the child, is good ground for a conviction for manslaughter. . carcinoma, or true cancer, and (2) sarcoma, whilst a third In a few instances parents have thus been convicted ; more line has been added to receive such cases of malignant frequently, however, they are acquitted of manslaughter, disease as cannot be safely allotted to either of these in which case it is still possible to convict them under headings. The tuberculous group of diseases has also the Cruelty to Children Act, 1894, of neglecting the child been subdivided and the endeavour has been made to in such a way as to cause unnecessary suffering. The --encourage more careful differentiation of the chief forms reason why a conviction for the more serious offence of this malady. By the introduction of italic type it has does not often take place is to be found in the natural been attempted to discourage the use in medical certificates difficulty of proving that if medical aid had been summoned of such indefinite and objectionable terms as " tabes mesen- the patient would have lived. It is not enough to prove terica," "diarrhoea," "gastro-enteritis," and puerperal that he might have lived, there must be positive evidence fever," and the authorised equivalents for these diseases that the death was caused or accelerated by the neglect. - are added in ordinary type. Inasmuch as the deaths have In some cases it is within the power of a medical - hitherto been classified on the same principle in each of the man to give such evidence and it is his duty to three divisions of the United Kingdom, with manifest con- do so unflinchingly, but it is clear that in others - venience to students of vital statistics, we may express the his opinion, whatever it may be, can hardly rest upon a hope that this new list will be adopted by the Registrars- sufficiently firm basis of fact and observation for him to -General of Ireland and Scotland, so that a similar uniformity enunciate it with confidence and in such cases there is no