The ordinary distinction between epithelioma proper and carcinoma is, therefore, vague and not scientific, and for the present will probably have to rest on the basis of a superficial, or deep cellular, disturbance. But, for the reasons already given, I protest against including all instances of epithelioma under cancer, as in the propaganda for early operations, and I do not include the mass of them in my studies as to the results of treatment. Inasmuch as the border line between the superficial and deep epithelial misbehavior is often so indistinct, it is difficult to designate as carcinoma all that might possibly belong there, but certain of them should be mentioned. In looking over the records of my patients in private and public practise I find at least 80 with the diagnosis of epithelioma whose disease was so malignant in its course that they should certainly be included in the carcinomatous class; these, therefore, appear in the following table, which gives also the sex and location of the cases, both of carcinoma and sarcoma: PRIVATE AND HOSPITAL CASES _Carcinoma_ _Male_ _Female_ _Total_ Breast 1 147 148 Uterus 8 8 Stomach 7 5 12 Liver 2 2 4 Lip 19 3 22 Mouth and tongue 17 3 20 Pharynx and esophagus 2 1 3 Jaw and neck 10 10 Nose 5 3 8 Orbital region 3 1 4 Penis 5 5 Other localities 12 17 29 ——— ——— ——— 83 190 273 _Sarcoma_ Head, face and neck 12 6 18 Trunk 5 6 11 Extremities 3 4 7 ——— ——— ——— 20 16 36 Totals 103 206 309