SEVENTH ANNUAL REPORT

OF THE

TRUSTEES OF THE

State Institute for the Study of Malignant Disease

FOR THE YEAR 1917

TRNSMITTED TO THE LEGISLATURE FEBRUARY 4, 1918

ALBANY

J. B. LYON COMPANY, PRINTERS

No. 26

IN SEΝΑΤΕ

FEBRUARY 4, 1918

Seventh Annual Report of the Trustees of the State Institute for the Study of Malignant Disease, for the Year 1917

The trustees of the State Institute for the Study of Malignant Disease respectfully transmit herewith to the Legislature their report for the year 1917.

In the absence of the Director, who is on military service, separate reports are presented from the different departments of the Institute.

Expenditures for the year ending June 30, 1917, including liabilities incurred for that period not yet paid, are as follows:

Small balances have reverted to the State under the general items for maintenance amounting to $152.26 and $74.82 in general plant service and $39.43 in repairs are available for use in the current year. In personal service $225.84 reverted to the State, most of which was the salary of the assistant in radiophysics, who was absent on military duty. A balance remained under wages temporary of $268.37, which is available for use in the current year.

The trustees have asked for the coming year some small increases in salary and some increases in the different items for maintenance which are absolutely necessary owing to the greatly advanced cost of materials and supplies of all kinds. Request has also been made for a new position, that of surgeon to the hospital of the Institute. During the past year we performed thirty-eight major and forty-five minor operations which were essential in the treatment and cure of these cases. It is of vital importance that we have someone who is competent in surgery to perform operations which are necessary in the research work of the hospital as there are certain cases in which X-ray or radium alone yields no results but when combined with surgery have resulted in an apparent cure. The work which is now under way along metabolic lines makes it absolutely essential to be able to remove tumor masses and then study the chemistry of the body. It is earnestly recommended that the position of surgeon in this Institute be created by this Legislature.

The Institute is handicapped by the absence of four of its employees who are on military duty; the Director, Dr. H. R. Gaylord, who is in the Army Ambulance Service and is now at Allentown, Pa., the radio-physicist, Mr. Thomas F. Cooke, who is at Camp Dix; the internist, Dr. John A. P. Millet, who is with Base Hospital No. 23, supposed to be now in France, and John Gray, laborer, who is at Camp Wadsworth, Spartanburg. These men are paid by the State the difference between their State and Federal salaries, so that we are able to fill their positions, if possible. No one, however, draws the salary of the Director, although his work is being done in his absence by the pathologist, Dr. Simpson. The entire salary of the Director reverts to the State.

Department of Pathology, in charge of Dr. Burton T. Simpson. The pathological material sent in for diagnosis continues to increase. We have received 2,300 specimens in the past year. While this is an increase over last year, we know that the number is less than normal on account of many surgeons who have sent us specimens in the past being away on military duty. We have received altogether, since making diagnosis free to the physicians of the State, over 8,000 specimens. This material has now become useful for statistical purposes and has been used in the past year in preparing papers which were read before several societies of the State. Many interesting facts have come to light in the study of these cases. A significant fact is that the malignant specimens have been reduced to 27 per cent of the total specimens received in the past year which shows the effect of the educational propaganda that has been made, advocating the early removal of all tumors or chronic lesions, before they undergo malignant change. The percentage of malignant specimens for the preceding ten years was 54 per cent, showing the results of this educational work to be very encouraging. Studies in recurrences of operated malignant tumors have shown us that we must extend the time in which we may safely say that the operation has effected a permanent cure. Recently we received a specimen showing recurrence of carcinoma in the scar of an operation for cancer of the breast which had been made thirteen years previously. Pathological studies have been made on the classification of the enlarged thyroids, or as commonly called, goitres which have been received at this Laboratory, especially respecting the pathological changes that are common to this vicinity and studies have also been made upon the more uncommon growths which we have received, especially the malignant myomata in their relation to previously existing leiomyomata.

As has been customary, this Laboratory has sectioned and filed all pathological research material which occurs in the course of research work at the Institute, including the autopsy studies. It has also carried on the studies of transplating mouse and chicken tumors and has made many attempts to establish new strains. The research work of this department has been especially centered upon methods to determine, if possible, the difference