examiple of what I am stating. After the brilliant results recorded by Sir Felix Seolon at last year's meeting of the Laryngological Section of the British Medical Association froii thyrotomy very few surgeons in this country, however -well aequainted they may be with the results obtained from any of the newer methods, would hesitate to urge his patient to undergo immiiediate operation in the hope of saving the much miiore serious and dangerous o)peration of laryngectomy. h-lence it comes that

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... iiost of the cases at present selected for treatmiient by-X rays. radium, or such agents are considered iinoperable, and, thanks to early diagnosis and the numiiber of men nowadays skilled in the use of the laryngoscope, these -re few in number. The case which I ani about to record wvas sent to me for treatmiient, and after carefully explaining imiatters to the patient the selection of the agent was left to me. One reason for selecting this case was the fact that it was taking a step fartlher than in applying it in ordinary ulcerating rodent ulcer. The feature of this case was the local induration as well as ulceration. I had no (loubt, however, as was proved afterwards, that by rays the mass could be b)roken down and improved. The diagnosis clinically and mnicroscopically was epithelioma. The patient was a man aged 78. Its history was that it began as a wart thirteen years before. After four or five years increased, but still slow growth took place, but one year ago signs appeared of rapid .development. The ulcerated parts indicated the seat of the old wart. The skin was afected externally, and the new growtlh extended tlhroughout the whole lengtlh of tlle ala. It was irregular in slhape and mor-e prominent anteriorly. For tlhe most part the skin was unbroken, but there was an ulcer about -1 in. in diameter on the point of the nose. The disease extended to thle septumi and passed inside the vestibule to a _ -,'~~~~I Epitheliorn;iO 10OS': A. vonditi) i bec;o ve treatmient. un iteied Jy rladiumt bromimdo condaitiou it pimetent ufter x-i-ay treatnment. distance of more than In so that tIme mucous membrane wvas involved, particula-rly on the outer wall near to the inferior turbinated body. Tle specimen of indium applied weighed io mg. It was of great radio-activity, and had pro-du1ed a distinct-burn oi the normal skin of the body which lasted for monthis. ailthough it had only been applied for one hiouir and thiroughi a plate of mica. Nevertheless, the fact that it was applied tirst, at a distance to thle patient and then iearer and near-er until it was practically resting on the skin; thlat some of the sittings gra(lually increased in duration were over forty-five minutes ; aiidi that thiirty-nine applications of m-dumlbromide failed to prodluce the slightest change as far as ITcould detect, it was unfair to submit the patient to furthier trial, and a: rays were commenced. Aks hiad been anticipated, thie hiard matter very speedily began to break down. An impro)vemnent was distinctly seen within a week. The applicationof thexrays was given at first daily and then at intervals. I-n all thlirty-seven applications were giv-en and in five weeks the treatmenmt was stopped. The progress continue-d steadily without treatment for one month afterwards, and the par-ts iniside, andi outside are now niearly well. In the first phiotograph the lesioni is seca before any treatment was applied, and the second shows its condition at the present day. One's first conclusion about the failure of radium to do anything in this case might be that the a rays are superior to the emanations of radium; doubtless in this case they were. but the question arises Is it not one of degree? Had I had salts of greater radio-activity and a greater quantity of them, or had we been able to apply them longer, the result miight have been different. The results in rodent ulcer lead one to suppose that this mlight be the case, and this leads me to another point which has often struck me when treating such1 diseases as rodent ulcer and epithelioma with any of these new agents, namely, apart fromii the class of disease, the patient's idiosyncrasies, and many other circumstances, there would seem to be a difference in response to treatment according to the state of the lesion at the time the agent is applied. When the parts are ulcerating or fungating, both of whiclh conditions may in a sense be looked upon as the results of attemipts on the part of the tissues to cast out disease, one seems often to get the quickest and afterwards a good result. Of course it has to be reiiembered in this connexion that as a rule the cases one gets for treatment are inoperable, and most of them are exactly in these conditions. Our experience of superficial tumours where the skin is unbroken is more limited so far. I lhave noticed the effect of the breaking down of the tissues in more than one case of epithelioma when being treated witlh radium. At present I have a serious case of epithelioma of the fauces and tongue under treatment. The patient was sent to me as quite inoperable, the lesion )eing far too old and extensive. A large proliferating mass had a projecting part the size of a small nut, which was steadily growing, muclh to the inconvenience of the patient in swallowing, and it seems to have been arrested and is now breaking down. I have also observed the same thing in another case of epitheliomnla of the fauces at present ulnder observation. Ire trying to answer the questions raised at the beginning of this paper, from wlhat I recorded in my previous communication published in the BRITISH MEDICAL JOURNAL in .1 une of this year, and all I have since learned, it is exident that the salts of radium have a therapeutic effect. These results, in my experience, have been in lu-pus and rodenit ulcer, for the nost part as yet in limited lesions, and where the agent could be applied directly to the affected part. The indications would point further to its being useful in the same class of affections as are at presenit beincr treated witlh the v rays, Finseni light, or hiiglh-frequency currents. Thirdly, that the experiments, so far, do not justify comparison between the salt of radium and other agents; and, lastly, tllat what is wan-ted at present is further investigation into the physiological and other properties of the different radiuii salts. ln pursuance of this I have tried to get salts of greater radioactivity and in muich larger quantity. buit no matker has been, so far, able to satisfy me upon the tests which I asked for, or to supply me with sufficient quantity. TilE satisfactory results obtained from the treatment of uterine fibroids by oil of cinnamon led to a specuilation concerning the therapeutic blue of the oil and its mo(le of action. This speculation dovetailed in, curiously enough, with a stu(ly of the cond tions connected with the formation of blood clot in the veins of pregnant an(a lying-in women. As a result I was led to exhibit the oil in full doses in an inoperable case of canicer of the breast. Certa-in reactions were then noticed, and a woman whose breast I intended to remove because of the presence of scirrhus growth was in consequence of these observations placedI under the influence