painless, and apparently harmless, it should be extirpated. The moral effect of this timely operation is generally good, bodily comfort is thereby promoted, and life is prolonged. It is therefore wise to operate as often as the tumor recurs.
According to the observations of many experienced surgeons, the average duration of life is a little less than three years from the first appearance of the tumor in cases of breast cancers that have not been subjected to any treatment. Does this not indicate the wisdom of prompt action in the great majority of cases, since the shortest average duration of life after operations which were not performed during the stage of benignity of the tumors is three years and a half, and since it has been shown that early operations afford the best chance for many years of immunity from recurrence?
Very large tumors are now rarely seen in comparison with the great numbers recorded before the introduction of ether, nitrous oxide, and chloroform as anæsthetic agents. The dread of surgical operations was formerly so great that patients were ready for the use of any means proposed rather than the knife, although many of the modes of treatment employed were cruel in the extreme, far exceeding any torture that could have been inflicted with cutting instruments. Thanks to the several modern modes of inducing anæsthesia, the patients of to-day need have little fear of the knife, for they are assured that they will be rendered insensible to pain during and for a time after operation. The surgeon, conscious that he is inflicting no pain, is then able to give his whole attention to the work in hand, and performs the operation in accordance with the recent improvements in surgical procedures and with the best modes of insuring asepticism of the wound.
The categorical answer to the initial question is, that at the earliest period of the development of any accessible tumor its complete extirpation is not only justifiable, but should be regarded as an eminently conservative and equally humane act.
