378 THE TREND OF THE RACE 



attributed to old age, and the deaths ascribed to "unknown 

 causes" in the American registration states had decreased in 1915 

 to less than one-tenth of the number reported in 1900. In the 

 same area and period the deaths from "tumor" had decreased to 

 about one-fourth of their previous figure. It is evident that 

 many deaths removed from these categories help to swell the 

 cancer death rate. 



King and Newsholme, as a result of their studies of the cancer 

 statistics of Frankfort-on-the-Main, came to the conclusion 

 in 1893 that "the increase in cancer is only apparent and not 

 real, and is due to improvement in diagnosis and more care- 

 ful certification of the causes of death. This is shown by the 

 fact that the whole of the increase has taken place in inaccessible 

 cancer difficult of diagnosis, while accessible cancer easily diag- 

 nosed has remained practically stationary." Willcox made a 

 further study of the Frankfort statistics for the period between 

 1890 and 1913, thereby gaining access to a much larger amount of 

 material (over 9,000 deaths) than that studied by King and 

 Newsholme. He found, in agreement with these authors, that 

 the reported increase of cancer was due to cancers located in 

 inaccessible parts, the death rate from accessible cancer showing 

 no general increase since the beginning of the original investiga- 

 tion in i860. He points out that in England and the United 

 States the death rate from appendicitis, despite much successful 

 surgery, has increased almost as much as the death rate from 

 cancer, owing probably to the fact that appendicitis was for- 

 merly diagnosed as some other malady. The conclusion of Prof. 

 Willcox's careful analysis of the problem is that "The cumulative 

 evidence that improvements in diagnosis and changes in age 

 composition explain away more than half and perhaps all of the 

 apparent increase in cancer mortality rebuts the presumption 

 raised by the figures and makes it probable, although far from 

 certain, that cancer mortality is not increasing." 



Our available data on the recent changes which have occurred 

 in the physical or mental characteristics of the race, are, I believe, 

 insufficient to afford any positive proof of decadence. Even if 



