The degree of malignancy varies with the lymph supply of that part of the body in which a cancer is situated. The richer the lymph supply, the greater the degree of malignancy. When properly applied, Roentgen irradiation diminishes the permeability of the lymph vessels, and reduces the possibility of metastasis occurring as well as preventing, in large measure, a recurrence. If the treatment is given before operation, an inoperable case may be converted into an operable one. Every malignant

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... th presents a separate and distinct problem which demands for its Solution consistent team work on tho part of the patient and the operator. The improvements in surgical technic have done much to reduce the number of recurrences of cancer, but expert surgeons are not satisfied with the results obtained from surgery. Roentgen irradiation of malignant growths must be powerful enough to destroy the neoplastia cells and to stimulate the healthy cells to resist the invasion. A small dose is-useless. Small doses given for a long time really favor the development of the growth, because, they stimulate, whereas they should destroy. I have treated quite a number of cases of lymphosareoma of the neck both before and after operation. The experience gained from treatment without operation has convinced me that these tumors will usually disappear under heavy Roentgen treatment, and that the results are more permanent, if the treatment is given first without operation. In nearly every case the mass can be made to disappear, if the treatment is begun before the glandular involvement is too extensive. After the growth has entirely disappeared, a second series of radiations should be begun as soon as the skin reaction has disappeared. It may be necessary to give a third or even a fourth series of treatments. I have patients apparently well for over four years, the diagnosis having been made microscopically. My most successful results in sarcoma have been confined chiefly to the lymph nodes. The cancer cases in which Roentgen treatment has been of the greatest service were those of involvement of the breast, cervical lymph nodes, and other external parts when internal metastasis bad not taken place. Roentgen therapy should be applied to deeply seated growths, not with the idea of efl'octing a cure, but to check the progress of the growth and to make tho patient more comfortable. Post-operative treatment should be begun immediately after the operation. The treatment must be given according to the best judgment of the roentgénologist, and not of the physician or surgeon referring the patient for treatment. Some unfavorable cases can be made favorable for operation by anteoperative treatment, and hopeless cases may be treated palliativèly with great relief to the patient. discussion Dr. George E. Pfaiilbr, Philadelphia i I saw a case of lymphosareoma involving the side of the neck which was considered hopeless from every point of view. I treated the patient with the Roentgen ray in the hope that I could give some relief. Within three months the tumor had undergone cystic degeneration. I referred the patient to a surgeon, who opened the cyst and drained it of a large amount of yellowish, pus-like fluid. It was assumed that my diagnosis was wrong, that the case was one of tuberculosis. Pathologic and clinical examination, including the lnooulation of guinea-pigs, failed to substantiate that assumption. J11 about six weeks recurrence was noted and the patient finally died of sarcoma. I merely cite the case to show what the Roentgen ray can do in these cases. I have bad cases of carcinoma 111 which the course was similar to that cited in the case of sarcoma. I agree with Dr.