THE EARLY EXTIRPATION OF TUMORS. 337 



indications of the earlier system, which those who reduced the 

 traditions to writing suffered to remain in ignorance of their real 

 meaning ; and, as Mr. McLennan, who collected those indications, 

 has shown,* there can be no reasonable doubt but that the Greeks 

 had a system of descents through mothers before they had one 

 through fathers. 



THE EARLY EXTIRPATION OF TUMORS. \ 



{ABSTRACT.) 

 By JOHN W. S. GOULEY, M. D., 



SURGEON TO BELLEVUE HOSPITAL. 



IN a paper, bearing the title of A Plea for the Early Extirpation 

 of Tumors, Dr. Gouley makes a succinct argument, based 

 upon long experience, in favor of removing morbid growths from 

 the human economy in a very early stage of their development. 

 What follows is therefrom abstracted, with the object of present- 

 ing to the general reader the main points discussed, and of call- 

 ing his attention to the importance of the subject, in consideration 

 of the fact that more than two thousand persons die annually 

 from the effects of cancerous tumors in the State of New York, 

 and in about the same proportion in other States and countries. 

 How this percentage of mortality may be lessened is suggested 

 in the course of the discussion. 



The paper begins with the question, At what period of the de- 

 velopment of a tumor is its extirpation justifiable ? The answers 

 to this question, for a long time, have been divided between early 

 and late surgical intervention and non-intervention. Some sur- 

 geons, at home and abroad, have favored and do now favor early 

 extirpation even in the case of benign tumors, but many advise 

 non-interference so long as tumors are small, painless, stationary, 

 or of slow growth. 



If it were generally known among intelligent people that great 

 numbers of innocent tumors sooner or later become malignant, 

 and that malignant tumors often simulate benign tumors and 

 remain quiescent for a great while, the sufferers would unhesitat- 

 ingly consent to the removal of these morbid growths in their in- 

 ception, long before the possible advent of serious mischiefs, or 

 when the cure might be effected by minor operations which would 

 leave the smallest scars, especially in such parts as the face, neck, 

 arms, or hands. 



In the discussion of the initial question the following points 



* Studies in Ancient History. 



f The original paper appeared in the New York Medical Journal, November 26, 1892. 

 tol xlii. — 23 



