THEORIES AND PROBLEMS OF CANCER 225 



in young women but the ulcers occur usually away from the 

 openings into and out of the stomach, while in men ulceration 

 usually occurs near the opening at which the food leaves the 

 stomach. Ulcers in the latter position are probably more 

 subject to continual irritation, which may account for cancer 

 of the stomach being common in men though it is rare in young- 

 women. It is possible that diet, in the broad sense, may have 

 some connexion in these cases with the occurrence of cancer 

 but it is going much too far to suggest, as has been done, 1 that 

 cancer is due to food and drink taken at a high temperature 

 and to the free use of wine, beer, spirits, flesh, coffee, tea and 

 tobacco. We may, I think, dismiss most of these from among 

 common causes of cancer. All the generally accepted causes 

 of external cancer involve irritation which is more or less 

 continuous and considerable in degree ; all are probably suf- 

 ficient to give rise to some local lesion and to keep up and 

 increase this lesion when it has once been established. Food 

 and drink if hot enough to produce such a result could 

 hardly be pleasant to take and we have no evidence to show 

 that numbers of people habitually take their food and drink 

 at a temperature which is unpleasant to themselves; even if 

 they did so, the irritation would last at most but a few minutes 

 at a time at intervals of several hours, even supposing that 

 all food at every meal were taken at a very high temperature ; 

 the commonest site of cancer of the stomach would not be 

 reached until after the food had cooled. It is difficult to see 

 how meat can act in such a manner as to produce inflammation 

 similar in degree and nature to that produced by the various 

 irritants which are accepted as causes of external cancer. 

 Much the same may be said with regard to the other articles 

 of diet mentioned. Diet may be among the causes of cancer 

 but we have not sufficient evidence at present to say that it is. 

 Trustworthy statistics are available only in the case of some 

 of the most civilised countries and even then are insufficient and 

 unsatisfactory in many respects. If it were possible to compare 

 the death rate from cancer in populations which did and did 

 not use alcohol, meat and other articles of diet, by means of 

 equally trustworthy statistics, it would be reasonable to form 

 a definite opinion upon these points; but reports of missionaries 

 and medical officers serving abroad as to the frequency of cancer 

 1 Rollo Russell, Preventable Cancer (Longmans, London, 1912). 



