which he advises an early circumcision; he admits, however,
to not having sufficient data to determine whether Jews and circumcised
persons are exempt from carcinoma of the penis; but as its usual
starting-point he evidently admits to be in the prepuce, circumcision
must certainly be a preventive to its appearance. Gross gives
substantially the same opinion as Agnew in this regard. Dr. John S.
Billings, in his article on the "Vital Statistics of the Jews," in the
January _North American Review_, of 1891, on the subject of cancer,
observes as follows:--

"As regards cancer and malignant tumors, we find that the deaths from
these causes among the Hebrews occur in about the same proportion to
deaths from other diseases as they do in the average population. But as
the ratio of deaths to population is less among the Jews, so the ratio
of deaths from malignant diseases to population is also less. Among the
living population the proportion found affected with cancer among the
Jews was 6.48 per 1000, while of those reported sick by the United
States census of 1880, for the general population, the proportion was
10.01 per 1000."

There are no convenient data as to the prevalence or percentage of cases
of cancer among the Arabian or Mohammedan population of Asia and Africa,
but the above comparison of 6.48 per 1000 among the Jews of the United
States, against 10.01 per 1000 of the general population, shows that the
circumcised race does, in the instance of cancer, certainly enjoy a
certain amount of immunity, having in this regard not quite such an
exemption as they enjoy from consumption, but still sufficient to assist
in making them longer-lived and more able to enjoy life and die a less
lingering and painful death.

It is surprising that, in view of the fact that carcinoma of the penis,
starting with such frequency in the prepuce, should have left any doubt
but that with the absence of this appendage there would follow less
liability to cancer. Cullerier informs us that he had several times
amputated the penis for cancerous diseases, but that he is unable to
tell us whether the persons were affected with phimosis, remarking that
on the last case he had observed the indurated remains of the prepuce;
he had, however, recognized the necessity of freely exposing the gland
in cases where, from continued irritation and inflammation, there was
danger of cancer formation.

Nelaton describes two varieties of cancer that affect the