THE EARLY EXTIRPATION OF TUMORS. 34 1 



painless, and apparently harmless, it should be extirpated. The 

 moral effect of this timely operation is generally good, bodily 

 comfort is thereby promoted, and life is prolonged. It is there- 

 fore wise to operate as often as the tumor recurs. 



According to the observations of many experienced surgeons, 

 the average duration of life is a little less than three years from 

 the first appearance of the tumor in cases of breast cancers that 

 have not been subjected to any treatment. Does this not indicate 

 the wisdom of prompt action in the great majority of cases, since 

 the shortest average duration of life after operations which were 

 not performed during the stage of benignity of the tumors is 

 three years and a half, and since it has been shown that early 

 operations afford the best chance for many years of immunity 

 from recurrence ? 



Very large tumors are now rarely seen in comparison with the 

 great numbers recorded before the introduction of ether, nitrous 

 oxide, and chloroform as ansesthetic agents. The dread of surgi- 

 cal operations was formerly so great that patients were ready for 

 the use of any means proposed rather than the knife, although 

 many of the modes of treatment employed were cruel in the ex- 

 treme, far exceeding any torture that could have been inflicted 

 with cutting instruments. Thanks to the several modern modes of 

 inducing anaesthesia, the patients of to-day need have little fear 

 of the knife, for they are assured that they will be rendered in- 

 sensible to pain during and for a time after operation. The sur- 

 geon, conscious that he is inflicting no pain, is then able to give 

 his whole attention to the work in hand, and performs the opera- 

 tion in accordance with the recent inrprovements in surgical pro- 

 cedures and with the best modes of insuring asepticism of the 

 wound. 



The categorical answer to the initial question is, that at the 

 earliest period of the development of any accessible tumor its 

 complete extirpation is not only justifiable, but should be regarded 

 as an eminently conservative and equally humane act. 



As described bj Mr. C. Willard Hayes, of the Schwatka Exploring Expedition, 

 tbe soutbern Alaskan coast mountains form a broad elevated belt with many scat- 

 tered peaks, of which none perhaps have an altitude of more than eight or nine 

 thousand feet, while there is no dominant chain. The southwestern front of the 

 range rises abruptly from the waters of the inland passage, forming a rugged bar- 

 rier to tbe interior. A few rivers have cut tbeir channels through the range, and 

 it is penetrated at varying distances by numerous deep fiords. Erom tbe head of 

 Lynn Canal northwestward the range decreases in altitude and probably spreads 

 out and merges in the broken plateau which occupies the eastern part of White 

 River basin. This region is practically unknown, however, and tbe precise rela- 

 tion of the Coast Range to the St. Elias Range has not vet been determined. 



