From the foregoing study, the following conclusions may be drawn:

First-That cancer in all parts of the body appears to be more prevalent than it was a few years ago.

Second-That cancer is, in the beginning, purely a local disease and may at that time be completely cured by operation.

Third-That other forms of treatment are not curative and should only be used in inoperable cases.

Fourth-That cancer of the cervix occurs much more frequently where lacerations exist, small lacerations being apparently as apt to produce the trouble as more extensive ones.

Fifth-That in every operation for lacerated cervix, the tissue removed should be subjected to a histological examination. Sixth-That in every case where there is the slightest suspicion of cancer, a section should be taken and subjected to examination.

Seventh-That occasionally from curettings of the uterus, a diagnosis of cancer may be made.

Eighth-Heredity does not appear to play any very important part in the etiology of cancer.

Ninth-The family physician is the one who, above all others, can do most to lessen the mortality in cancers of all kinds, and especially those occurring in the uterus.

ABORTIONS.

BY R. C. ROBE, M. D., PUEBLO, COLO.

This paper is not presented as in any sense a scientific dissertation on the etiology, pathology, symptomatology, diagnosis and treatment of abortions. But as agitation from time to time has a restraining influence, if I succeed in arousing a discussion or sentiment which will aid in checking one of the greatest evils of this or any past generation, the purpose of this paper will have been accomplished.

Reliable statistics on this subject are difficult to obtain, but so far as we are able to generalize we cannot conclude that abortions, either accidental or criminal, are on the increase. However, it is well known that there is throughout our own country, and some European nations, a falling birth rate. Especially is this true of the so-called aristocracy of our larger cities, and to some extent in the rural districts, a fact which may well engage the attention of social economists and others interested in preserving national life of the highest American type.

The reasons for abortion are accidental, criminal and the intentional limitation of the family.

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The accidental include those brought about by injuries, syphilis, fevers, the "abortion habit," or means other than intentional. Of these there are a great many and need the most. careful attention at the hands of the profession that a goodly proportion may be prevented, and that those which are inevitable may receive such care as that the sequelæ may be the least harmful to the patient.

The criminal cases are most common as a result of illicit coition either among the unmarried, or where there has been infidelity on the part of a husband or wife in their relations with

another married or single person. Of course the first procedure under such circumstances is to either inquire among friends for something that will "induce menstruation," then visit a drug store to procure the necessary ingredients, or else go at once to a physician to have an abortion produced. In most communities these people generally know where to go to be helped out of trouble. I say this with a blush of sadness, to think that any man or woman bearing the sacred title of doctor of medicine can be bartered with to commit a crime, in no sense less heinous than to take a gun and shoot down the woman who confronts him as the victim of misfortune. Of course, I make no reference here to the induction of abortions where a dead foetus is present to cause infection, or where some mitigating condition in the physical make-up of the woman makes it necessary as a life-saving measure. That is an entirely different proposition. We all know the difficulty of obtaining convicting testimony against the class of our professional brothers who can be prevailed upon to do this kind of work, as well as the temptation from a lucrative standpoint which there is for the conscienceless doctor, who makes a specialty of this sort of murder. However, we must not forget the odium which sometimes falls on the physician who is called in when may be an abortion is taking place, or has done so, which has been self induced and afterward is charged by the victim to the doctor in order to clear herself.

The third class of cases is among married people, and occur, not because of illegitimacy, but simply because the people either want no children at all, or having one or two, want no more. This is largely the result of the evils of our social system. People of moderate means think their rise in the world, either financially or socially, or both, will be hindered by even a small family of children. The rich, many of them, do not care to take the time from social functions necessary to a healthy maternity and the devotion to family which it requires. Some even scorn the very thought of such vile things, as though it was a disgrace to bear children. How different the ancient Jews, who were the healthiest race the world has ever produced, among whom the disgrace was to the barren. Go up and down any of our rich thoroughfares in the cities and one cannot help being impressed with the

idea of the small number of children he sees. On the other hand, go into the industrial sections of the same cities and it seems as a veritable bee hive from which swarm countless numbers of children. From the standpoint of financial ability to care for an offspring, we would think the conditions ought to be reversed. Yet these same rich people will, many of them, spend hundreds of dollars, or even thousands, and sacrifice the health of the woman in the case, rather than be denied a few months in social life. And there are doctors who, for the money there is in it, will force themselves into the belief that "it is all right to help the poor woman out of trouble."

With the desire to avoid maternity the knowledge of means used not only for preventing conception, but also for inducing abortions, is industriously sought after, and is passed about among women as that which is invaluable. Women ask each other, "Well, what do you do to keep from having children? It seems that nothing I do does any good." Sometimes they will venture to take the family doctor into their confidence, thinking he can tell them something harmless and sure. The poor, unfortunate girl, to hide her shame, cannot trust her associates, but goes directly to some abortionist, either in person or by correspondence, but to call later on some reputable physician to complete the job secundum artem.

If we turn for a moment to consider the results of the abortion practice, the conscientious physician must throw up his hands in holy horror at the contemplation. Infections, more or less severe, are the rule, rather than the exception. It may be endometritis, metritis, parametritis, salpingitis, ovaritis, cystitis, peritonitis, or an inflammation followed by suppuration, septicæmia or pyæmia. But it seldom appears on the death certificate with the record of the proper contributing cause attached.

But granting that the majority survive, we have as a rule following a few consecutive abortions, a destruction of fecundity as a result of the injury to the normal soil of conception. And with this power removed, we have a chronic invalid on our hands. Acute infections become, to a greater or less extent, chronic, the patient is a chronic sufferer, with almost any of the ills of life