378 THE TREND OF THE RACE 
attributed to old age, and the deaths ascribed to “unknown 
bauses in the American registration states had decreased in 1915 
tor legs:than one-tenth of the number reported in 1900. In the 
same;atea and period the deaths from ‘‘tumor” had decreased to 
albowt one-fourth of their previous figure. It is evident that 
maaarydeaths removed from these categories help to swell the 
cancercdeath rate. 
oiKing 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 
tredlziand is due to improvement in diagnosis and more care- 
fulicethification 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- 
fhosedihas remained practically stationary.” Willcox made a 
‘hurthersstudy of the Frankfort statistics for the period between 
48gdfind 1913, thereby gaining access to a much larger amount of 
Amaiterjal (over 9,000 deaths) than that studied by King and 
Newsbolme. He found, in agreement with these authors, that 
dhe reported increase of cancer was due to cancers located in 
tindacessible parts, the death rate from accessible cancer showing 
no general increase since the beginning of the original investiga- 
‘tidnsfin, 1860. He points out that in England and the United 
Statescthe death rate from appendicitis, despite much successful 
rbsirpery, has increased almost as much as the death rate from 
schmters owing probably to the fact that appendicitis was for- 
meri diagnosed as some other malady. The conclusion of Prof. 
-Willcox’s careful analysis of the problem is that “The cumulative 
seuidence that improvements in diagnosis and changes in age 
-composition explain away more than half and perhaps all of the 
-appatent increase in cancer mortality rebuts the presumption 
taised;by the figures and makes it probable, although far from 
‘aertainj; that cancer mortality is not increasing.” 
; 2Ownavailable data on the recent changes which have occurred 
«im thé physical or mental characteristics of the race, are, I believe, 
‘Anguffacient to afford any positive proof of decadence. Even if 
