26 KEVIEW — TROPICAL MEDICINE, ETC. 



Cancer — 3. Taku care of mouth and teeth. 4. Destroy dressings from discharging, malignant uleerations. 5. Attend to 



continued non-malignant sores and tnmours. Excise cancerous and douljtful tumours early. 7. Practise abstinence from 



alcohol, tobacco, excessive meat eating, and foods which leave waste ijroducts. 8. Avoid all unnecessary 



familiarity, especially with strangers. 9. Attend carefully to kitchen hygiene and the hygiene of food generally. 



Brand advances many very suggestive points, especially on the infectiousness and 

 auto-inoculability of cancer, and points out that it is impossible for the "carcinoma cell" to 

 bo the true parasite as suggested by Butlin. He recommends the examination of fresh, 

 living carcinoma cells on the warm stage of the microscope, and suggests that the new device 

 of Gordon which enables a good magnification of 7000 diameters to be obtained, and the 

 system of dark-field illumination introduced by Siedentopf may greatly facilitate cancer 

 research. He strongly advocates cleanliness in its widest sense, showing how very readily 

 food, especially vegetables and fruit, can become contaminated, and denounces earth burial, 

 advocating cremation. 



As regards distribution, Sutherland' presents statistics for the Punjab, which, as he says, 

 tend to show that cancer is not a common disease there, but that such cases as occur 

 apparently affect all classes. He also notes that the nature of the diet does not seem to 

 affect the incidence of cancer in the Punjab. The same, he says, is true of alcohol, syphilis 

 and malaria. From India^* during 1904, 146 cases of malignant new growth were reported 

 to the Imperial Cancer Research Fund amongst vegetarian natives, 137 amongst natives living 

 mainly on flesh diet, and 222 amongst natives living on a mixed diet. " Cancer in the British 

 Colonies " is the title of a paper in the Journal of Tropical Medicine of March 1st, 1905,"* and 

 a point of interest to us in the Sudan is the statement that the disease has not been seen 

 amongst natives of the Gambia, Ashanti and Natal, and that it is said to be rare in 

 British Central Africa, the Eastern African Protectorate, Southern Nigeria and on the 

 Gold Coast. 



Thus Hearsey says that amongst the natives of British Central Africa, though cancer 

 occurs, it is of the utmost rarity, while non-malignant growths are relatively common. 



Amongst the Chinese, cancer is rare (Clark), and the same is true of the Malay States, 

 Jamaica and Ceylon, while in British New Guinea, where be it noted the Papuans cook all 

 their food and live chiefly on vegetables and fish, the disease seems to be absent (Craigen). 



As regards the Sudan, I have records of only ten cases of malignant tumour examined in 

 these laboratories during the past five years. Of these, half were carcinomatous and half 

 sarcomatous. I think it may be taken that malignant disease is not common amongst natives 

 of the Sudan even though in the northern parts the native, in many places, has come into 

 association with Europeans. I cannot say much about the matter from a clinical 

 standpoint, but I understand that most cases of new growth dealt with surgically at the 

 Military and Civil hospitals in Khartoum are sent to the laboratories for diagnosis and, if 

 this be the case, neoplasms play no great part in the pathological field. 



Dr. Watcrfield of the Sudan Medical Department confirms this statement, and his 

 experience goes to show that tumours of all kinds are rare in the Sudan. 



At my request. Colonel Hunter, P.M.O., kindly sent out a letter of enquiry to his 

 Medical OflScers, asking for their opinions regarding the prevalence of cancer in their 

 districts. 



Captain Thompson, writing from Wad Medani in the Blue Nile Province, reports : — 



" So far as I have been through this Province up to date, I have seen no cases of malignant disease." He 

 adds : " I may say that I saw a case of scirrhus of the breast in a woman at Kassala in 1906, and a suspicious case 

 in a, boy in this Province, who, however, did not come here for treatment as directed." 



Curiously enough, shortly after this was written Captain Thompson sent in for 

 examination the tissues from a well-marked case of epithelioma of the foot. 



Captain Brakenridge, S.M.O., Bahr-El-Ghazal, answered: — 



" I have never seen a single ease of malignant disease in this Province in about twenty-one months I have 

 served here. In fact, in my eight years' service in the Egyptian Army I only remember to have seen one 

 epithelioma of the tongue in a Sudanese, and one sarcoma of the neck in an Egyptian." 



Captain Anderson replied from El Obeid, Kordofan : — 



" During a year spent in the Province, in which time I have inspected widely in all directions and seen 

 many hundred sick, I have never come across a single case of malignant disease amongst the Arab, Nuba and 



• Sutherland, D. W. (November, 1904), " Cancer in the Punjab." Indian Medical Gazette, p. 425, Vol. XXXIX. 

 » " Scientific Reports of the Imperial Cancer Research Fund," No. 2, Part I, 1905. 

 ° Quoting " Blue Book on Cancer in the Colonies, 190G." 



• Article not consulted in the original. 



