suspected. A few days ago a person came into my office bringing two specimens of urine, his own and his wife's, for examination, saying that he did not suppose there was anything wrong, but he always had it examined every year. He made the common mistake of bringing a sample of the urine that had been passed in the morning on rising. I told him he wasted his money by depending upon an analysis of that, and required four ounces of the mixed urine of twenty-four hours with a memorandum of the total quantity passed in that time. Examination under the circumstances revealed that his wife had chronic interstitial nephritis. I was wondering if it would be practical to treat ligatures by soaking in Peroxide of Hydrogen. The Peroxide, as we know, is an active deodorizing agent, and as I understand it, these agents are germicides because of their oxidizing or chlorinizing properties.

Dr. FISKE: I have used the Hydrogen of Peroxide with excellent results in severe ulcerations due to in-growing toe-nails; bathing with the Hydrogen and then applying a pledget of cotton and Glycerine.

Dr. HELMUTH: I have used the Peroxide of Hydrogen in solution ofor, for the purpose of washing out large abscesses. I have a case now, one of abscess of the neck, developed from hygroma, in which it is being used. I have also employed it after amputations of the tongue, and resections of the jaw, where there is a great deal of fœtor. I do not know about its effects as vulnerary. I use it as a deodorizer, and think it one of the best. In proportion of 1 to 6, I have used it to wash out uterus. I have never seen trouble from the application of the Bichloride to wounds other than of serous substances.

Reputable physicians are sometimes deterred from making use of valuable methods of cure because of the notoriety given such plans by advertising specialists. I have that degree of confidence in the discrimination of the general public to believe that not even an advertising physician will achieve any great degree of success without some basis, slight perhaps, but still a perceptible foundation on which to rest his claims. There are a considerable number of specialists throughout the country advertising their ability to cure cancer without the use of the knife. So far as I have been able to ascertain, they very generally use some form of caustic application. They thrive, financially, in

*Semi-Annual Meeting.

some instances at least; their establishments are thronged with people; they do remove tumors; and their grateful patients are not infrequently ready to testify to the skill and success of their operations.

I have taken some little pains to investigate and I know that, while in many instances the growths removed are benign and that in other instances where they are malignant they speedily recur, yet in a certain number of cases truly malignant growths are thus removed and they do not recur, or at least the patient is free from recurrence at a period of time sufficiently remote to lead me to believe that some times this plan of removal is better than that of operating with the knife.

My opportunity for investigation in the field has not been very extensive, but I hope sometime in the future to be able to speak intelligently on the subject from my own personal experience. In the meantime a word as to the theory: The malignant tumors are of low vitality. They perish under a degree of irritation or inflammation that normal tissues withstand. Any caustic application to a malignant growth will exert a selective action in destroying the neoplasm. Scattered cells remote from the apparent center of infiltration will thus be destroyed that the knife would quite likely leave as a nucleus for further growth. I believe that to totally extirpate a cancer in its early stages is to cure it. This doctrine is rapidly becoming one of general acceptation. Gross, in his classical work on tumors of the mammary gland, accepts it, and while he justly, I think, condemns the general use of the caustics in those cases he recommends in certain instances, after the operation with the knife, that the exposed surfaces be sprayed with a strong solution of Chloride of Zinc or be seared with the hot iron. Dr. Willis, my colleague on the staff of the Brooklyn Homœopathic Hospital, has in his operations for the removal of cancerous breasts pretty generally packed the wound with marine lint, thus inducing active inflammation and suppuration. And I think his success is in a measure due to this practice, whereby outlying deposits of diseased tissue, infiltrated fat and glandular structures perish in the inflammatory reaction.

A

It is not, however, this class of cases to which caustic applications are peculiarly adapted. In the various forms of epithelioma, attacking the face and neck preferably, it finds its greatest field of usefulness. number of different caustics are used. Nitric acid, pure Carbolic acid, Vienna paste, Marsden's paste, Caustic potash, Pyrogallic acid, etc. In the superficial varieties Nitric acid is an efficient means. The action is quick. The pain insignificant. The Vienna paste is said to cause intense pain. Marsden's paste is certainly efficient. The pain caused

by it is severe but not intolerable and may be mitigated by combining a little Morphia with it. It seems to have an elective affinity for epitheliomatous tissues. It is contra-indicated of course when the mucous membrane is affected. Dr. A. R. Robinson of New York, author of "A Manual of Dermatology," Prof. of Dermatology at the Polyclinic, and who may safely be said to stand at the head in his speciality, teaches this method of practice to his classes and recommends it in his writings. It takes no small amount of moral courage to thus proclaim the methods that have heretofore been monopolized by the quacks, and to set them on the pedestal of respectability.

I have been fortunate enough to see a number of cases treated by Dr. Robinson and I can vouch for the authenticity of his cures. In the few cases I have treated myself my success has been unequivocal, but I have as yet not had the cases under observation long enough to certify to their permanency. One of the remarkable features of this method of treatment, to my mind, is the slight scar and resultant deformity.

A familiarity with this plan of treatment and its creditable results will often enable us to operate on cases at that early stage when the best results are to be expected and when patients are most loth to consent to the use of the knife. Indeed it justifies us in removing neoplasms at a state of development when we as surgeons are unwilling to submit our patients to the knife, at a stage when the diagnosis is a matter of probability rather than of certainty. I remember once to have refused to operate on a fistula with the elastic ligature, because, as I told my patient, it "wasn't surgical." This form of argument did not seem to materially impress him, and the result was that another practitioner cured my case. The lesson has not been lost upon me I trust and I shall not refuse to cure cancer with caustic because it lacks the dramatic elements of an operation with the knife.

It is obvious that this treatment would be improper in deep seated glandular growths, except as an adjuvant to removal with the knife. But still there is a large class of cases where it promises the best results, the quickest, the safest and the most agreeable cure.

A CASE SHOWING THE DESTRUCTIVE CAUTERY EFFECTS OF AN ELECTRIC LIGHT WIRE.

BY M. O. TERRY, M. D.,

UTICA, N. Y.

In these days of wonderful invention it is not strange that human life is correspondingly imperiled. Electricity as now used presents perhaps greater danger to life than any other of the improvements over our former ways of living.

I have had recently a case which shows that the system can withstand a very powerful current--one such as passes over a wire for the purpose of lighting the street-without producing death.

Mr. S., æt. 35, nervo-bilious temperament, while on a pole thirty-five feet from the ground performing his dangerous duty of examining defective lights, received a current. His foot caught in such a manner as to hold his body from falling. He was suspended over one hour with head down before he was conscious. He remembered nothing in regard to the shock. Descending the pole he made his way homeward. I saw him at 6 o'clock in the morning. He was not suffering from any shock, nor could it be said that he had any symptoms of shock during his convalescence. He simply had received the terrible effects of an electric cautery. The palm surface of several fingers were severely cauterized. The current also passed over the inner portion of the thigh on each side and over the dorsal portion of the penis, removing threefourths of the skin and one-fourth of a deep portion of the gland penis. Results: The skin sloughed and rapid destruction of the organ seemed imminent. I gave no remedies internally as there seemed no indication for any.

For the sloughing process I used Bromine, about, to arrest it and used a weaker solution later as a stimulant. As the line of demarcation formed I cut the dead tissue away from healthy structure, and in dressing used Iodoform freely in the form of powder over which medicated gauze was applied, and over this absorbent cotton. An operation was performed removing redundant tissue, the remains of a former