H. EDWIN LEWIS, M. D., Managing Editor

IRA S. WILE, M. D., Associate Editor

No longer are injuries and loss of lives regarded as evidence of national spirit. Noise and riot, fires and firearms do not increase the measure of national pride nor tend to increase the meaning of a significant day. To the minds of those most keenly interested the Fourth of July appeals as a day of rejoicing, consecrated to a re-dedication of citizens to national ideals.

The "safe and sane Fourth" has swept over the nation as a plea for rational and dignified ceremonies upon the day that symbolizes the birth, in safety and sanity, of a Republican form of Government.

It is difficult to realize that on the Fourth of July, 1903, the mode of enjoying a national holiday was such as to result in the death or injury of 4,449 persons and probably many more which were not reported. Hospitals, dispensaries, physicians, firemen, policemen were constantly alert to safeguard life and property. Despite their zeal and enthusiasm the frightful toll was taken. Young America was mildly rioting in the name of Liberty.

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Slaughter and flames have given way to pageants, parades, picnics, patriotic assemblages, and organized efforts to establish a semblance of order and sanctity. Cannons, pistols, giant crackers, bombs and fireworks with their appeal to primitive. senses are now relegated to a surbordinate place. In their stead have developed constructive municipal plans for the education and elevation of citizens.

A New Significance to the Fourth of July. It is particularly noteworthy that in this year, when the spirit of war is resplendent in wonderful ardor and when souls are fired with basic feelings of earnest sacrifice, the celebration of Independence Day should have been so quietly fervent and calmly ennobling. The deep felt spirit of Independence Day was everywhere manifest in a serious declaration of devotion to this country, in a pledging of allegiance to the flag and the institutions for which it stands. Everywhere there was the recognition of new meaning in an appeal for national solidarity in the face of an international crisis.

Thruout the length and breadth of the land, human life possesses new value. Courage, health and high ideals are appreciated as the rightful basis of true independence. Fourth of July is to be a celebrating of national vitality-a memorial of achievements-a consecration to unity, free

dom and indomitable high purposes for humanity.

For the first time in the history of the country, hyphenation has not shown its snaky head. All who celebrated. were Americans, regardless of their place of birth or ancestry. Fourth of July has been reborn, a truly American institution symbolizing constructive democracy that protects and conserves the best in national idealism. It typifies the harmony of a nation formed from elements originating from every corner of the globe.

It is unlikely that the lapse of years will ever see the chaotic and destructive celebrations which characterized the past generation. In its new interpretation it will have a loftier significance and its spirit will be transformed into patterns of action that will redound to the greater glory and honor of a free and liberty loving nation.

The Prevalence of Cancer and the Need for Early Diagnosis.-That cancer is a widely spread disease is a statement which admits of no denial. That it is increasing among civilized people is also an assertion which may be allowed, altho, probably it is not increasing at the very rapid rate attributed to it by some statisticians. However, the disease is deadly, loathsome and sufficiently prevalent to stamp it as one of the greatest of the menaces of the human race. To check effectually the inroads of cancer would be a work to mark an epoch in the prevention and treatment of disease, while its eradication would surely be hailed as the consummation of science in saving human life. At present, no such end is in view, can it be said that it is likely to

nor

be even in the near future. During the past few years the endeavors of the medical profession have been very properly concentrated on the initiation and employment of means calculated to curb the spread of cancer. Even the attainment of this most laudable object is beset with many and diverse difficulties. In order to stay the plague of cancer, several stipulations must be laid down. One point in this connection stands out conspicuously and it is the only one. which will be discussed-that, in our existing state of knowledge, an early diagnosis is absolutely necessary to ensure successful treatment.

There is general and almost universal agreement among authorities on the subject that the only logical treatment of the malady is the employment of prompt operative measures. A complete removal of the disease focus is the only method upon which reliance can be placed with any degree of certainty. But, and here is the main stumbling block to successful operation, the complete removal of the disease focus is only possible when the disease is local, when metastasis into distant organs has not already taken place. Consequently, good results from operation hinge entirely upon an early and correct diagnosis.

How are early and correct diagnoses of cancer to be obtained?

Altho in dealing with the question of how to procure an early and satisfactory diagnosis of cancer, ground is being covered which has been traversed frequently within recent years, it is more or less of an essential prelude to the matter in hand, the biopsy of cancer. The conclusion was come to after due deliberation by cancer experts in this country, that the only way by which cancer in its operable stages could be diag

nosed was by securing the cooperation of the public. Persons suffering from the disease, and especially women, are generally speaking, ignorant of the early symptoms. Sometimes women neglect to seek the advice of a medical man from a false sense of modesty. In the great majority of instances, however, it is ignorance of the manner in which the disease first manifests itself that is responsible for cancer developing into the inoperable stage. A recognition of this fact led many of the leaders in surgery and medicine in America to recommend that a campaign of education be launched for the purpose of providing information as to the early symptoms of cancer. Thus, those in whom such symptoms were present would be given warning that the advice of a skilled medical practitioner was called for, so that, if necessary, operative procedures could be instituted before it was too

late.

The conception of this campaign was excellent and in practice, it has justified to a large extent the hopes of its inaugurators.

Naturally, the boards of health thruout the country have taken an active part in the prosecution of this educative campaign. As befits the well earned reputation of the Health Department of New York City, particular activity has been displayed in disseminating literature bearing upon the early diagnosis of cancer and, in fact, all available means have been employed in spreading such knowledge broadcast.

It is absolutely essential that any information given to the public, and particularly on as vital a matter as that of cancer, should be strictly accurate; that is to say, in accordance with the views of those who by research and clinical experience are warranted in speaking with authority. It is evident,

if this rule be not followed, that education in this direction is worse than useless. Recently, the New York Health Department has deviated from this rule and has sent forth written advice concerning the diagnosis of cancer which must be characterized as highly dangerous.

Biopsy of Suspected Cancer Tissue.— Some six months or so ago, the New York Department of Health announced that it had just completed and put into operation a plan by which the physicians of the city were invited to submit specimens of tissue for miscroscopic diagnosis. According to the Publicity Bureau of the Department:

"The scheme lends itself particularly to the early diagnosis of superficial and other accessible cancers, the lips, tongue, cervix, breast, etc., but is no less applicable to the investigation of all suspicious lesions from which it is possible to remove small particles of tissue for microscopic examination." * * * "In these the operation is free from danger and easy of performance, the degree of pain is negligible, and the result of microscopic investigations is practically always such as to determine the diagnosis with scientific exactitude, and frequently is responsible for the institution of timely operative procedures and the saving of life."

Altho, it is a matter of the utmost importance that an early diagnosis of cancer should be made, the plan suggested and put into practice by the New York Health Department is of so dangerous a nature that it is extraordinary it should have ever been. fostered by the Department. Our highly esteemed contemporary, the Medical Record, rightly, at once in its editorial pages severely criticized the scheme, pointing out that no more efficacious way of favoring