168 THE TREATMENT OF DISEASES. 



other continent. In. some parts of North America and China it is also frequent, 

 whilst in South America, in Africa (except Egypt), and the greater part of Asia it is 

 not of frequent occurrence. In England, cancer is least common in the north-western 

 and western parts of the kingdom, including Wales, but throughout the most 

 elevated southern and middle districts it is common. It has been pointed out thai 

 the distribution of cancer follows the course of the great rivers after their formation f 

 when they are passing through the low-lying valley lands liable to overflowing and 

 its attendant dangers. There is no evidence to show that cancer is influenced by the 

 density of the population, or that it is proportionately of more common occurrence 

 in large towns than in country districts. There is reason for believing that its 

 prevalence increases with the advance of civilisation. 



It is sometimes said that cancer may arise from a blow or kick ; but this is very 

 doubtful. At all events, in such cases the patient must have been very strongly pre- 

 disposed to cancer. Many women are apt to attribute the origin of the complaint tc* 

 a squeeze on the breast, and to reproach themselves on this score. We must admit 

 that we have some difficulty in believing that such a trivial cause could be in any 

 way operative ; if it were, the disease would undoubtedly be more common. 



As a rule, there are no precursory symptoms of cancer, and in the majority of 

 cases the first sign is the detection of some growth or tumour. After a time it is 

 noticed that the patient is getting thinner, and day by day weaker and more 

 deficient in muscular power. The appetite is generally bad, and often the patient 

 takes scarcely anything to eat. The skin becomes loose, and acquires a peculiar 

 lemon or straw colour, which can be distinguished from the yellowness of jaundice 

 by not affecting the whites of the eyes. There is often great depression of the 

 spirits, but the intellect remains unimpaired. 



And do these symptoms indicate the presence of cancer 1 Certainly not, for the 

 majority of them are common to, we might almost say, dozens of complaints. We 

 are seldom warranted in deciding that a case is cancer unless we can detect the 

 presence of a tumour. And if, then, a tumour is found, is it cancer 1 Again 110 ; 

 decidedly not. There are many swellings and tumours which are of the most 

 innocent description, and never do anybody harm. It is most likely that that 

 lump you have been worrying yourself about, and thinking was a cancer, is of not 

 the slightest importance, and will disappear in time. There are "fatty tumours," 

 lumps of fat, and all kinds of things that anybody who is not a doctor might 

 mistake for a coming cancer. But you have been losing flesh, have you 1 Well, and 

 what then ? You cannot expect to be the same weight all your life. Your weight 

 fluctuates more or less just as everything else does. Sometimes you gain a little, 

 and sometimes you lose. We will be bound that if you got yourself weighed you 

 would find that you had not lost a pound in a month. But your appetite has fallen 

 off? Well, we do not wonder at it. The fact is that a change of air would do you 

 more good than anything. A few days at Brighton or Ramsgate would soon set you 

 up again ; even Saturday to Monday is better than nothing. But you are looking 

 yellow 1 ? Dare say you are, yellow as a guinea. It is just what we should expect 

 when you are cooped up in-doors all day. But if you really feel anxious about the 

 swelling, go and see a doctor by all means, and get him to examine it. Tell him 



