Bronchogenic Carcinoma of the lung in Europeans
is now a common disease, whilst it is rare in the
Bantu races of South Africa. The writer has been
associated with the Silicosis Medical Bureau for the
past fifteen years and has checked up all the records
since the inception of the Bureau in August 1916.
Nearly every miner, even if he leaves the mines, has a post -mortem examination and the lungs are forwarded
from all parts of the Union of South Africa to the
Bureau for examination. As the Chairman of the
Silicosis Medical Bureau writes in the 1944 -1948
"Under the Silicosis Act it is in the
interests of the dependents of a miner that an autopsy should be performed on his death and the lungs
forwarded to the Bureau for examination. There are indeed very few
cases in which no post-mortem
examination is conducted."
A full definition of the Bantu races will be
given in the Chapter on "History and Anthropology"
when it will be noted that they include all the Native
tribes of Southern Africa with the exception of the
Hottentots and Bushmen. In South Africa, they are
also referred to as "Africans, Natives or Kaffirs ".
The arguments used in this thesis are mainly
based on the clinical histories and post-mortem findings in 6 Bantu cases of "Primary Carcinoma of the
Lung" in 11,365 post-mortems of Bantu miners as compared to 114 cases of "Bronchial Carcinoma" in 8,468
post-mortems of European miners, all conducted during
the period 1916 -1949.
Bronchial Carcinoma is also uncommon in Bantus
who are not miners.
Amongst the Bantu miners during the period 1925-
1933, Charles Berman (8) found 229 cases of "Primary
Carcinoma of the Liver ". The same group of Bantu
miners show a high incidence of "Primary Carcinoma of
the Liver" and a low incidence of "Primary Carcinoma
of the Lung".
In this thesis, an attempt will be made to discuss the aetiology of "Primary Cancer of the Lung ",
mainly from an anthropathological viewpoint and to try
and explain why in a city like Johannesburg, where in
terms of the international recommendations, accurate
statistics are kept by the health authorities, primary
cancer of the lung is about ten times as common in the
European as it is in the Bantu.