BY EUGEN HIRSCHFELD, JI.D. 95 



Of these figures the most interesting are those concerning 

 England and Ireland. It is easier to institute comparisons 

 between these two countries, which do not show an appreciable 

 difference in climate. While England and Wales have a mor- 

 tality of cancer of 54 per 100,000 living, that of Ireland only 

 amounts to 37. It may be contended that, perhaps owing to 

 the less careful certification and registration of deaths in Ireland, 

 a certain number of cases of cancer are overlooked and returned 

 under another classification. But may I be allowed to point out 

 that the same argument may be made to apply also in the 

 opposite direction. Is it not likely that a faulty certification 

 will attribute to cancer a good few deaths which have been 

 caused by other obscure diseases, thus unduly swelling the 

 returns under the heading of Cancer, and I believe that the 

 latter eventuality is of not too infrequent occurrence, because 

 cancer is really a common cause of death with the general public. 

 But even admitting the possibility that a certain number of cases 

 are not diagnosed, it is utterly out of question to put this forward 

 as the sole explanation of the vast difference, as it is shown 

 by our figures. Moreover, despite the improved methods of 

 diagnosis of the last ten years, the increase in Ireland has been 

 smaller than in England during the corresponding period, and 

 stands now (1891) 46 to 69. 



What is the cause of this relative immunity of the 

 Irish people ? One of the first ideas that suggest them- 

 selves is that it may be a difference in diet, owing to 

 the small quantity of meat that is being consumed in Ireland. 

 This view seems to be confirmed by the fact that Prussia, where 

 the consumption of meat on account of its high price is very 

 limited, exhibits even a lower percentage than Ireland (31). But 

 on the other hand the percentage in Italy is high, though very 

 little meat is eaten by the vast mass of its population ; while 

 some of the Australian Colonies, as New South Wales and 

 Queensland, who cannot be accused of abstemiousness in meat, 

 occupy a still more favourable position in the cancer mortality 

 than Ireland. However, the increase of malignant tumours is 

 very rapid in Australia, and some of the colonies have already 

 succeeded in outstripping the mother country — as Victoria and 

 Tasmania. 



