Although all statistics show a steady and alarming increase in the death rate from cancer when regarded and treated as a surgical disease, it is probable that this course will be persisted in until sufficient evidence is accumulated to satisfy the medical profession and the laity that relief can be obtained by other means. For, as the drowning person catches at a straw, so the cancer patient hopes against hope that an operation will be permanently successful in this particular case, though the odds are so immeasurably against it. You have already seen some patients who have illustrated the possibility of controlling cancer by dietary and medical measures, and in the next lecture I shall hope to show and report other cases and present statistics which will further illustrate this possibility. We will now consider briefly what this dietary and medical treatment of cancer consists in, and how it is to be carried out, and also the bearing of all this on the prophylaxis of cancer. In order to make this clear I must more or less repeat some things that I have said in former lectures.

We have seen that, as shown by the kidney excretion and the condition of the blood, the metabolism is deranged, both in the early and late stages of cancer. We have seen that the nitrogenous and sulphur partition is materially different from that of health, and reason indicates that in some way protein, or rather its metabolism, is at fault. We have seen that there is a deficiency in the urinary secretion, not only as to the actual quantity, but also that the total urinary solids are commonly far below the normal, often not half the amount required for the body weight of the individual. We have seen that the intestinal excretion is commonly imperfect and that constipation is the rule in these cases, even long before the administration of anodynes. The secretion from the skin is also generally defective, and the tissues dry and harsh, and the saliva is generally acid.

All these, and perhaps other, elements point to a faulty performance of the bodily functions, and to erroneous or deficient elaboration and elimination of the waste products of the body; these latter are known to be toxic to animals, and we know that in the human system they lead to an auto-intoxication and derangement of the blood stream, which in turn causes faulty cell and tissue action. Such a condition is recognized in gout, as causing the local inflammatory manifestations, and in rheumatism, which is so common in cancer subjects. All recognize that obesity is due to some nutritive change, naturally acting through the blood, and it is well known that cancer is peculiarly rebellious in those subject to obesity. Diabetes likewise relates to a peculiar blood condition, and there have been many observations concerning the relation of diabetes to cancer. All these diseases and many more have their foundation in faulty nutrition, depending largely on dietary errors.

We see, then, that to understand and rightly treat the systemic condition belonging to cancer, which is indeed its basic factor, one needs to take a very broad view of the complex processes in the human system which pertain to metabolism and nutrition. This is indeed quite a different proposition from the very simple surgical view which regards the tumor as a local matter, of absolutely unknown origin, which only needs the knife to end its career. Deranged, disturbed, perverted nutrition is then the bottom fact of all erroneous growth, whether it be obesity or a benign or malignant tumor.

Now it must be acknowledged that we are yet in the dark regarding the exact or precise blood changes which precede and accompany cancer; but in our last and also in previous lectures we saw that the blood did exhibit changes which were evidently connected with the production and continuance of the disease. Until all these matters which have been referred to have been accurately determined by laboratory work and investigation we are forced, as in time past, and as is still the case also in regard to many diseases at the present time, to rest our judgment and treatment on clinical experience, joined with deductive observation, based on such knowledge as we have. And this we have endeavored to do in these and former lectures.

Coming down, then, to the actual and practical facts relating to the dietary and medical treatment of cancer, we readily see that the real cancer problem relates to placing the patient in such a normal or ideal state of life that the function of nutrition is performed in an exactly proper manner, as nature intended, and from which man has erred through the manifold temptations incident to our artificial existence, in the presence of our so-called advanced civilization; for we have seen that all over the world cancer has steadily increased with the intensity of human progress.

Since first writing on the subject under discussion medical reviewers have spoken as though I regarded the eating of meat as the sole cause of cancer, and enforced absence therefrom as the single element in its cure and prevention. From what I have just said you can see that this is by no means true. But that I regard animal protein as a fertile cause of the derangement of metabolism which leads up to and fosters the growth of cancer, is most certainly true; this I have developed largely in my lectures two years ago. While there are many elements which contribute to the deranged blood stream of cancer, the question of diet is so preeminently important that we must treat of it very fully. For, as in gout the continuance of an indulgence in Port and Madeira wine in excess would invalidate any attempt to cure the trouble permanently, so in cancer an excess of animal, or even a large amount of vegetable protein, militates against any effort to remove the disease medically; this is probably true also of coffee and alcohol.

The first point, therefore, is to remove from the intake of food everything which furnishes an excess, or even such a modicum, of nitrogenous matter as is found by laboratory means to be badly metabolized. The second step is to eliminate effete nitrogenous elements from the system, including the cancerous mass, and the third step is to restore the system to a proper tone by remedies and measures which improve the blood and nutrition. It may happen, therefore, that in treating a cancer patient over the long time necessary to effect a cure, the greatest number and variety of remedies may be employed from time to time, as intelligent observation and experience may indicate, to restore and hold the metabolism and nutrition in a perfectly normal state: the erroneous action of certain individual body cells which in the aggregate we call cancer, will then cease to exist, as is seen in cured cases.

As, however, the diet is the basic element on which all health, good and bad, rests it is all important that the physician and patient come to a perfect understanding as to how this is to be carried out. And remember, gentlemen, that there is no absolute or fixed time during which this diet is to be continued; or rather, there is no fixed time when it may be discontinued, and my patients are made to understand that it is at their own risk that it is stopped. For safety from recurrence a proper diet should be persisted in indefinitely or even permanently.

I recognize that it is often very difficult to persuade patients to adopt and faithfully follow out this course of procedure for a long enough time to secure perfect results, so obsessed is the medical profession and the laity with the idea that surgery offers the only hope of cancer. Numbers of patients, many of whom I have followed for some years, now entirely freed from undoubted cancer, which had been previously diagnosed as such by prominent surgeons, have told me that they had suffered much more distress from the persistent solicitations of their physician, surgeon, or friends, urging an operation, than they had from the treatment or from the disease itself, as it slowly vanished under the measures employed.

But as the true facts in regard to the ultimate results of operations are becoming known, and as it is more generally realized and accepted that the disease is amenable to rightly directed dietary and medical treatment, patients are coming more and more to the Medical Clinic for Cancer in this hospital, and adhering more and more faithfully to treatment. Thus far, however, these have been mostly recurrent cases, in which further operations were impossible, or primarily inoperative cases. To illustrate the satisfactory treatment of early cases I shall have to depend largely on those observed in private practice during the last thirty years, of whom I shall try to show you some; for as yet primary and operable cases are referred directly to the surgeons of the hospital for operation.

At first the idea of an absolutely vegetarian diet is distasteful and seemingly impossible to many patients, but when it is patiently explained, as to the reason for its employment and the real benefit to be derived from it, it is readily acquiesced in and commonly carried out very faithfully; indeed many a patient has asserted that they are more than pleased, and have no desire for animal food.

Among the poorer classes especially it has been hard to make matters clear, and to facilitate the work of our Medical Clinic for Cancer I prepared a dietary card, or folder, with a daily menu, which has now been in very satisfactory use by hundreds of patients in private and public practice. To make the whole matter of this line of treatment perfectly clear, certain statements in regard to cancer have been presented on the first page, and on the last page some directions as to diet and mode of life of a practical character, as you will see on the samples now passed around, known as the “green card diet slip.” I may say that the hospital has already used up one thousand of these sheets given to patients and to physicians making inquiries, and there have just been printed this revised edition of five thousand copies, which will be gladly furnished to those who can make good use of them for cancer patients.