BY EUGEN HIRSCHFEIiD, M.D. 67 



mania, 593 ; Western Australia, 131. It is, perhaps, not quite 

 correct to accept without qualification the statement that cancer 

 has been the cause of death in all these cases. There is no 

 doubt that a certain proportion of deaths classified under the 

 heading " Cancer" have in reality been caused by a different 

 class of tumour, mostly Sarcomata. For practical purposes, 

 however, it is quite impossible to make such a distinction. They 

 are comparatively rare, and equal cancer as far as malignant 

 progress is concerned. The differential diagnosis can only be 

 established by microscopical examination, which I am afraid has 

 not so far, even to a small extent, formed the basis of the returns 

 of any Registrar-General. It might be, perhaps, more appro- 

 priate to use the term " malignant tumour," which covers both 

 classes. 



I do not intend to deal in this paper with all the details of 

 this important subject, but I shall restrict myself to the principal 

 outlines. In a series of future papers these details, for which 

 the material is already contained in the accompanying tables, 

 will be treated separately, so as not to disturb or complicate a 

 clear general view. 



The results of the investigations to which I want to draw 

 your attention to-night are the following : — 



1. The rapid increase of cancer in all the Australian 

 colonies. 



2. The unequal distribution of the disease amongst males 

 and females. 



3. The unequal prevalence of cancer in the different 

 Australian provinces. 



It goes without saying that with the increasing population 

 and consequent increasing number of cases of deaths the number 

 of cases caused by any specific disease like cancer must be fsr 

 greater now than it was twenty years ago. But tlie increase in 

 cancer has been out of proportion to the growing population and 

 to the cases of death due to other diseases. Let us take, for 

 instance, Victoria. In 1861 not quite fifteen persons died from 

 cancer amongst 100,000 living, while in 1891 more than four 

 times this number (61) succumbed to it. The difference becomes 

 still more considerable when we consider its prevalence amongst 



