cases. The most important requisite is early recognition of the disease. But the removal must be most thorough, not merely of the diseased tissues, but the entire gland in which it is beginning, with the sound tissues for an inch all round. And, of course, nothing but the knife can effect such a removal, cleanly, quickly, and painlessly. In spite of a most exhaustive search, for at least five centuries past, by both doctor, patient, and quack, no drug, paste, caustic, or reagent of any sort has yet been discovered which can be relied upon to even destroy the diseased tissue with any certainty whatever. If strong enough to act at all they eat away remorselessly cancer and healthy tissue alike, producing the most frightful mutilations; most of them contain either arsenic or corrosive sublimate, and are extremely liable to cause fatal poisoning by absorption; and as they take weeks to destroy a growth of any size, and are extremely painful, the cumulative agony inflicted by them is something fearful. To see patients suffering literally the tortures of the damned for weeks and even months at a stretch in the futile attempt to "eat away" a cancer by zinc chloride or arsenic paste, when they can have it removed in twenty minutes under chloroform with absolute certainty and safety, and without a single twinge of pain, solely from sheer panic at the very name of the knife, is one of the most astonishing experiences in medicine. The "knife-dread" is one of the most unreasoning and unreasonable superstitions which lingers on into the nineteenth century.

The same thing must be said of internal remedies. Myriads of drugs have been vaunted as cures―arsenic, sulphur, golden seal, bloodroot, condurango, clover-tea, each has been tried by hundreds of eager physicians and thousands of anxious victims ready to clutch at any straw, but not one has been found which has the slightest permanent effect upon the course of the malady.

So that the remorseless logic of events thus far seems to have practically limited us to operation as a means of cure. Fortunately it is a fairly effective means and rapidly improving, while, under aseptic surgery, its risks have been reduced almost to the vanishing-point. Fifty years ago we operated chiefly with the hope of prolonging life or relieving pain; now we expect to cure from 30 to 60 per cent. of our cases, if we can see them early enough. This great improvement is due partly to the wonderful advances of modern surgery, but more to greater skill in recognising the very earliest stages of the disease, and to a wider and more intelligent recognition on the part of our patients of the importance of an early diagnosis.

It cannot be too strongly emphasised that cancer in its early stages is a distinctly curable disease; in its later almost incurable.

As by a merciful coincidence, indeed in the very nature of the malady, it usually attacks superfluous and declining organs, it is

possible to remove it completely, without danger to life, in the great majority of cases. Indeed, almost the only organs in which cancer at all commonly begins, which cannot be themselves removed entirely or in part, if necessary, are the stomach and liver. And even these are rapidly coming within the field of operation, for large portions of each, indeed the entire stomach, have already been removed for malignant disease with complete, though so far only temporary, success."

If the disease returns after operation, or has spread too far to permit of removal, before it is seen by the surgeon, we have still a palliative left, the greatest gift of the gods to suffering humanity— opium, which will render the sunset hours of life not only almost painless, but even comfortable.

Cancer, ruthless as it is, has one redeeming feature: it does not threaten the existence of the race, nor ruin the individual life. The best of the life-work is done, the family reared, the vantageground for the world's progress won, before the dart is launched. Between dying of consumption at twenty-five and of cancer at fifty lies practically an entire lifetime. Few of us would hesitate for a moment, if given our choice. Surely even two years of suffering is not too much to pay for fifty of vigorous, successful life.

WOODS HUTCHINSON, M.D.

Schlatter's celebrated case lived fourteen months after removal of the entire stomach for cancer of the pylorus, and gained twenty pounds in weight, but died ultimately of a recurrence of the disease in the liver.

THE INDEPENDENCE OF CUBA.

WHILST

HILST the English Press, since the termination of the American-Spanish War, has almost unanimously taken it for granted that Cuba belongs to the United States-that is to say, that she has become a possession by right of conquest, for a colony she certainly is not and cannot be-it may be permissible to a Cuban at the present critical moment to point out this signal error and to place before the English reader some few facts wherewith to justify the claim for complete independence on the part of his compatriots.

There are in reality so many good reasons to be advanced in favour of our absolute independence that it is impossible to do justice to them in the course of one brief article. As, however, the English public seem in no way to realise the importance of the problems now pressing for solution in the Caribbean Sea, nor the great interests at stake in that region, I will endeavour to summarise them to the best of my ability.

These problems may be conveniently classified as political, financial and social. The enemies of Cuba's independence profess to see no other way to solve them than by annexation to the United States, and can bring forward no better arguments than those drawn from fancy-mere suppositions, in a word, such as the possibility of intestine disturbances in the near future. These prophets of evil have not even the merit of originality, and certainly not the honest conviction of the prophets of Israel who preached the destruction of their people. The prophets of Biblical times, when denouncing the evil, at any rate also advised the remedies; whereas these modern prophets, when predicting the disasters that are in store for Cuba, can recommend but one plan for averting them, and that is the political annihilation of our country by annexing it to the North

American Republic. By those who oppose the emancipation of Cuba I mean those who oppose it bona fide, and not in any sense the moneygrabbers, office-hunters, representatives of Trusts, subsidised newspaper men, &c., who do not deserve that their opinions be considered, for they carry no weight with the honest and intelligent reader.

The partisans of annexation, although mostly foreigners, American and Spanish residents on the island, can count, it is true, some Cubans among them who thus shamelessly, before trial, declare their countrymen to be incapable of self-government. But, be it said to the honour of the Cubans, these are few indeed, and their number is steadily decreasing. In their shortsightedness and lack of moral courage, they cannot conceive of any law or order, any freedom or prosperity for the island, outside the protective shadow of alien bayonets. Born and bred in servility, with the tyrant's sword ever before them, these poor specimens of our race do not find in themselves sufficient strength or dignity to cast aside their imaginary fears and lead a life of political freedom.

Such terror-stricken mortals resemble a poor blind man who, having recovered his sight through some wonderful operation which he perhaps resisted, shrinks back with amazement from the glorious rays of the sun, and demands to be led to some dark place, the sudden glare proving too strong for eyes long unaccustomed to the light of day.

POLITICS.

The independence of Cuba is as necessary to the natives as wholesome food to hungry people. It is, moreover, a matter wherein is concerned their pride, not less than their dignity and self-respect. Should the Cubans, after their long fight of half a century, now tamely renounce their rights, by such an act alone will they prove themselves unworthy of the freedom they wrested from the Spaniards at the cost of so many lives, and of the streams of blood with which the rich soil of Cuba has been drenched. It is not sufficient that a brave people should have won their freedom after a long and heroic struggle; to maintain it intact in the hour of triumph, as well as to lay securely the foundation of future greatness, is at once their privilege and their sacred duty. Cuba independent will have a rôle to play; will hold a place in the concert of sovereign nations; will be mistress of her destinies, and will make her own history. The Cuban flag, emblem of so many sacrifices, will represent a living fact. Its lonely star, which symbolises their aspirations, will then emphasise the integrity of their island home. Caressed by gentle breezes, or proudly carried in the storm, as it floats from land to land, it will be pointed out as the emblem of the honest and unyielding patriotism of a manly people.

The desire for independence is a sentiment natural to every human being. Those men and nations who have proclaimed the principle of liberty and defended it to the bitter end have received religious respect in every age; and the men and nation who have best incarnated it, proclaimed it by speech and deed, have been those whom humanity has most admired. Ancient Greece does not appear to us noble and glorious so much on account of the high degree of civilisation to which she attained, as through her indomitable spirit of independence. Leonidas fighting at Thermoplyæ against the hosts of Xerxes in defence of his native land, gave more days of glory to Greece than the divine Plato with all his philosophy; or rather, these days of glory went to produce a Plato. The heroism and sublime beauty of the conduct of Sagunto and Numancia, who preferred to die free rather than to live enslaved, has no parallel in history. The manly spirit of independence has been an unfailing fount of inspiration to the poets of every country. On the other hand, everything resembling cowardice and servility has always been derided and treated with repugnance, even by the victors. Far from desiring an easy victory, really great conquerors admire and treat with respect those who have offered a stubborn resistance.

Cuba, although relatively small, on account of her unique geographical position and the inexhaustible richness of her soil is assured a brilliant future as an independent nation. Twenty years hence her prosperity, if allowed free expansion, will be something wonderful, and her ports will be the rendezvous for vessels of all nations engaged in trade in that part of the world. Owing to her commercial treaties Cuban products will have easy access to all markets. The Customs revenues, under a moderate tariff and honest management, will almost suffice to defray the expenses of the Administration. Agriculture and industry, relieved from the crushing taxation of the past, will be raised to a high degree of perfection, thus enabling our goods to compete advantageously with those of other nations. Lawe will be passed favouring the immigration of a desirable class of whites from all lands without respect to race or creed. Such immigration, scattered through the island, will bring into existence new industries and form new centres of population. Thus will Cuba recover her lost economic equilibrium, for a country cannot depend on a single industry, such as sugar or tobacco raising, if prosperity is to rest on a solid foundation. The cultivation of a special product, no matter how great may be the returns for a time, will sooner or later bring a nation to financial distress, the economical system of a country being somewhat similar to the physical system of a living organism, where the extraordinary development of a single limb or organ is necessarily followed by the impairment of the others, so that, as a consequence, disease and death threaten the individual.