a remarkable diminution in mortality will be noticed. Those diseases which may be mentioned in this connection are, small-pox, scarlet fever, typhus, enteric and simple continued fever, and phthisis. In tabular form the figures showing the mortality rates may be given as follows:

Table of Annual Death Rate for the Undermentioned Diseases to a Million Persons Living in Groups of Years, 1881-1890.

1861-1865. 1866-1870. 1871-1875. 1876-1880. 1881-1886.1886-1890.

With these figures, then, before us, and those to which we have drawn attention on another page, does it not appear to be plain that the declining death-rates from some of the chief causes, and the annual increase in the mortality from cancer are merely an instance of cause and effect. If cancer as a disease were showing an augmenting death-rate from any other cause than this, we should expect that the increase would prevail at the early ages of life as well as at the latter ages. As Dr. Ogle, however, has pointed out, this is not the case. There has been an actual diminution in the number of cases of cancer in children; in other words, malignant disease in the early years of life is becoming less frequent, pointing to the emphatic conclusion that whatever may be the real fons et origo of the malady its virulence is almost entirely expended upon persons of adult age whose survival of the exigencies of childhood have brought them within the age period of cancer.

So far as we know at present nothing can strictly be said to be a cause of cancer. It develops where least expected, without apparent reason, and without affording the least warning of its forthcoming. There is a general belief, both within the profession and outside of it, that the habit of smoking has some influence in provoking the outbreak of cancer. This influence is due to the irritation of the stem of the pipe where the latter presses on the lip, and thus accounts for the cases of cancer of the lower lip which are met with in men. Probably also cancer of the tongue in smokers is to be explained in the same way. But there is no reason for believing that smoking has any closer connection with cancer than this. In other words, a man must be, so to speak, predisposed to cancer, or must have in him those elements, what

ever they may be, necessary to the development of cancer, before the irritation arising from the stem of a pipe, or any other source of irritation, would be sufficient to disturb the nutrition of a part so as to lead to the development of a malignant growth.

The next question which obtrudes itself in connection with this subject is Is cancer hereditary? In former days this was a very debated point among pathologists and surgeons, and the balance of opinion at one time was decidedly in favour of regarding cancer as an hereditary disease. But the theory nowadays must be held to be untenable. The natural history, so to speak, of cancer does not fulfil in any respect that of a disease whose features are hereditarily transmitted. For example, a man may be gouty without having had an attack of gout, the origin of his gout having been hereditary. Again a man may suffer from the effects of inherited tuberculosis without being actually tuberculous. These are the kinds of diseases whose presence becomes impressed upon the offspring by hereditary transmission. But, on the contrary, there is no such thing as a cancerous stomach, a cancerous neuralgia, a cancerous ache or pain-without cancer. A person is either cancerous or he is not, and he is not so until he becomes so by exhibiting in some organ or part the disease in its primary form. It is clear, then, that if a person has inherited cancer he has not inherited much; for, obviously, cancer must be an exceptionally benign disease before it becomes cancer in those cases, indeed, in which it is believed to be inherited; for a man with an inherited cancerous taint must patiently wait until the near approach of the last scene of all which ends his strange eventful history, before his morbid patrimony can become an accomplished fact. With respect, however, to the hereditary transmission of a predisposition to cancer there is more to be said; although even here, of course, no definite knowledge exists. It is quite possible that a predisposition to cancer may be transmitted from parent to child, and if this be the case the fact would go far to explain the collective cases of cancer which have been recorded as occurring in certain families. But the consideration of this feature in the life history of malignant disease. naturally leads to the all-important question: Is cancer or is it not infectious or contagious? In the absence of any direct evidence to the contrary it has usually been held that an outbreak of cancer was in no way associated with any element of infection or contagion. Cancer, it has been said, can neither be "caught" nor "given." The idea underlying this general belief was that the disease commenced

de novo in each person whom it attacked, and also that its consecutive appearance in the members of a single family was due to hereditary transmission. It is doubtful, however, whether, in view of our recent knowledge, this general opinion can be maintained. Almost every year facts are accumulating which inevitably point to cancer being a disease of parasitic origin. And probably, at no distant date, as has been observed above, a cancer microbe will be discovered. If this should actually prove to be the case, clearly we should have to reconsider our position with respect to the question of the infectivity of the disease. In former days no definite knowledge existed in regard to the infectivity of tuberculosisat all events, no evidence such as could be practically made use of in support of any suggestion of the kind was available; and, naturally, no precautions were taken in this direction to prevent the dissemination of the disease. Since, however, the discovery by Koch of the tubercle bacillus, all our preconceived notions upon this point have been completely revolutionised. Tuberculosis is now known to be a highly infective disease-so much so that in Germany cases of pulmonary tuberculosis are placed in the same wards with patients suffering from zymotic affections, and the utmost precautions are taken in the disinfection of rooms lately occupied by tuberculous victims. If, then, tuberculosis be infective by means of its bacillus, analogy would teach us that cancer would be infective, if a characteristic organism were shown to be the fons et origo of malignant formations. It must, therefore, be conceded that the possibility of cancer being infectious and contagious is quite within the bounds of reason, although our lack of knowledge at the present time prevents any definite statement from being made upon this point.

HUGI PERCY DUNN.

CAN THE HOUSE OF COMMONS BE SAVED?

THE

HE recent fight on the floor of the House of Commons has come as a climax to many violent scenes during the present Session, suggesting the possible deterioration of our great governing assembly, the mother of free Parliaments, into a mere ungovernable mob. Can anything be done to save the House from the dangers which are threatening to impair so fatally its efficiency as a governing body, and to inflict on the democratic ideal the severest wound that it has received in modern times? For if popular government breaks down in England, where will it survive?

The fact is, democracy is at the present moment in a very critical and dangerous position. It is passing through a transition stage. The great constitutional work of the next fifty years, in every popularly governed country, will be the organisation of democracy as a means of government. Until quite lately in the history of the modern world, democracy has been in opposition; and now, wherever it takes up the reins of government, it is hampered on every hand by the code of opposition ethics that it inherits-the dogmas of rebellion and the doctrines of popular combat that have almost elevated themselves into a positive system of philosophy. But as experience comes into play, the statesmen of democracy inevitably discover the one-sided nature of all these doctrines and dogmas. The "sacred right of insurrection," the preposterous claims of minorities born of the exaggerated powers in the hands of majorities, the doctrines of rights, and all the political ethics of the French Revolution, turn out to be very unsubstantial material to build with, though excellent weapons of destruction.

It follows that unless humanity is to tread in the footsteps of the French, through their fatal adherence to one-sided doctrines, into the alternate slough of reaction and disillusion, democracy must set about organising itself, and putting its house in order. It must develop a doctrine of duties; it must give efficient power to majorities; it must

limit the liberty of rebellion. And nowhere is this need felt more profoundly at the present moment than in the British House of Commons, which is a peculiar product of the fighting democratic spirit. The British House of Commons was the guide and beacon to democracy-to use an expressive vulgarism-" on the make." Shall it not show the way to democracy in possession ?

At present it shows few signs of it. Just as the great trend of Christianity which broke away from Rome in the sixteenth century still goes by the name of "Protestantism," and has never entirely emerged from the negative attitude which was then essential to it, so English Liberalism tarries by the customs and forms, the manners and habits of revolt. The House of Commons has been stereotyped as a machine of protest, and the difficulty of the present situation is that it has little or nothing left to protest against. And yet "the Queen's Government must be carried on," and the country will in time grow tired of being provided with incessant "scenes" and huge amphitheatrical dialectical displays, or even fights on the floor of the House, in place of the sober, serious, russet-coated business of looking after the interests of a great community. Governing is, after all, a serious business, as most men have in the long run found. "I would rather be a poor fisherman," was Danton's final judgment on the matter, at the melancholy close of a somewhat stormy experience. And precisely as the functions of the House of Commons extend with the daily growing demand for wider Socialistic legislation, the clamour for Parliamentary reorganisation will grow stronger and stronger every day.. Already a membership of Parliament is growing a serious thing. It requires the best men that the country can give. And from this point of view there is little to complain of. Perhaps the personnel of the Commons has never been higher than in the present assembly. This House contains a greater number of devoted, high-minded, hard-working, and truly representative men than perhaps any that have preceded it. But though the personnel is going up, the procedure lags behind. You only collect all these men to waste their time. The business of Supply is still transacted with little expert criticism, but with endless formalities and intolerable delays. The twaddle of the bores swamps the effective criti cism of the experts. And similarly with legislation. Bills are still discussed and re-discussed-five times in each House-in a manne that darkens counsel, and could only be necessary in a time of tyrannical power frequently misused. The feeling of responsibility in