It is undoubtedly true that some of these cases which are inoperable when first seen could have been operated on at a much earlier period, with as much success as follows in those in which this is tried. But we have already seen in the last lecture how small a proportion of these selected cases survive a long time; for we have yet to find statistics regarding those who have been traced even as long as ten years. In my previous lectures I reported concerning two patients with undoubted cancer of the breast who had been watched for sixteen years, with no trace of the trouble remaining, and two others who had been seen each for nine years; these latter have been watched since, and have been seen recently, eleven years after beginning treatment, with the same results, all without operation. These cases had all been diagnosed as undoubted cancer by competent surgeons, some eminent, and had refused operation, which had been urged. Later I shall hope to relate other similar instances of early cancer. Inoperable cancer, comprising at least 50 per cent of all cases applying to the surgeon, presents many features of interest and worthy of consideration. The reasons for inoperability may be grouped as follows: 1. Those occurring in regions quite inaccessible, as in the brain, esophagus, liver, pancreas, etc. 2. Those otherwise accessible, but which have advanced too far before seeking surgical relief, occurring in many locations. 3. Those in accessible regions where experience has shown that recurrence is pretty sure to take place, such as advanced cases in the oral cavity, bladder, prostate, etc. 4. Those which have recurred after repeated operations, with extensive spreading of the disease, as in many cases of the breast, uterus, etc. 5. Those with already very great metastatic involvement, in many regions, presenting a true carcinosis. 6. Those in close proximity to or involving vital organs, blood vessels, ureters, etc. 7. Those in which there are other reasons, such as advanced age, lowered vitality, great cachexia, etc. 8. Those who absolutely refuse to be treated with the knife. There is no necessity of troubling you with details as to the character or appearance of inoperable cancer, which are dwelt on in standard works, as our study relates rather to the causes of the disease and the means of arresting its progress. Nor need I dwell much further on this distressing aspect of cancer, for I believe that all see the necessity of seeking some other measures than operative surgery to aid in solving the question of relieving the present condition of affairs. It is for this mass of otherwise hopeless cases that any reasonable method of treatment is worthy of serious consideration, both for the measure of relief which may be secured along many lines by exactly the proper care, and especially for the possibilities of its value in regard to prophylaxis.