184 CAUSE AND DURATION 



recorded by Van der Byl 13 were males and 16 females; 

 whilst the mean age of the males was 41, females 50. 

 Walshe states that he finds hepatic cancer more frequent 

 in males than in females, in the proportion of 27 to 18, 

 very rare before 35 or 40 years, most common between 

 the ages of 50 and 70, two-thirds of the total number of 

 deaths occurring within the latter periods. 



CAUSES. Of special causes of hepatic cancer, predis- 

 posing or otherwise, none have been discovered. The 

 disease is met with in the anaemic as well as in the 

 plethoric ; in the badly fed as well as in the well fed ; 

 in the peasant's hut, the cot of the mechanic; the home- 

 stead of the farmer, the house of the well-to-do trades- 

 man, the baronial halls of our aristocracy, and the 

 places of royalty. Like its prototype, phthisis, it spares 

 neither young or old, male or female, the peasant, or the 

 prince. Spirituous liquors, which so easily derange and 

 even destroy the secreting functions and nutrition of the 

 liver, do not predispose to cancer of that organ. The 

 same may be said of climate, as we find it endemic in 

 both warm and cold count i 



DURATION. It is impossible to determine accurately 

 the duration of cancer in the liver, as its premonitory 

 8 is in most cases so obseure as to elude the most 

 careful investigation. Tin-re are instances in which 

 the progress is slow and almost latent for many years 

 until the very highest grade of marasmus wasting is 

 attained ; and there are other instances where tin- 

 ease runs a rapid course, and terminates fatally at the end 

 of seven or eight weeks. In such cases it is usually 

 attended with fever, tenderness in the hepatic region, 

 and jaundice. M. Andral relates a case in which death 



