THE manv papers which have lately appeared upon the action of iodine preparations upon skin in the practice of surgeons seem to me to be a reincarnation of the old dread of skin. I have not yet seen evidence that other sutrgeons have carried the ritual of iodine into the regions wllicll it has invaded in lily practice for many vears. The end of anotlher year prompts me to record my faith in the cult of iodine evolved unconsciously from the days when "Bryant's sherry," otherwise "dilutecl

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... e of iodine," was in general use -with me instead of carbolic acid-1 in 20-which played havoc with mny skin, and more than once produced carboluria. It is over twenty years ago that a German sailor was brouglht to the Cardiff Infirmary about midnight withi a " huge bark " of his shin, caused by the cranik-shaft of an engine. The damage had received " first aid " treatment, for "' the bark " had been plugged witlh waste wrunig out of oil. The skin of the shin for a few inches below the knee had been stripped up, carrying with it periosteuim anid ligamentum patellae. The knee-joint had been freely opened, and into it the "first aid" dressinglhad been introduced. c A large bucketful of " Bryant's sherry " was prepared, and the patient was anaesthetized and turned on his face in order to get the fully flexed knee-joint into the lotioni. After thorough cleansing by immersion and mopping, the parts were replaced and the joint put at rest by splinting. Next miiorninig by daylight I was alarmed to find that my lhanids were discoloured by iodine, showing that the 'slerry " was stronger than was usual in h-ly practice; the patient's skin was stained in the same way, and this caused me somne anxiety, for I feared "irritation." My fears turned out to be groundless, for tlle case did well, and my dread of an overdose of the iodine preparation vanished. The nman returned some months afterwards witlh tlle complimients of a Gernman professor upon tlle good result obtained by the treatnient. Slowly and by cautious steps I got inlto the practice of applying the undiluted tincture by means of the eye end of a nieedle to the redness whiclh often resulted in suture holes before the use of gloves was introduced into my practice in 1898. An account of this appeared in the BRITISH MEDICAL JOURNAL in January, 1899, the first paper, I believe, to be published in this country on tlle subject. I Wvell remenmber that in one of the first cases in whlich I used screwvs, a case of fractured tibia witlh displacement due to oblique illjury, in private practice in 1896, redness and siglis of " irritation " were observed a few days after operationi; removal of all sutures witli free swabbing of tile wound witlh the tincture gave a liappy restult, fcr all Nvent well. From that time until the presellt tinctuire of iodine lhas on and off played an imiiportant part in m-iy routille practice in almost everv region uponi wlicil operations are done, and I wvill indicate briefly the condlitions in wliichl I think it is of great use, because it lias a strong action as an antiseptic, and tllere is little or no tendenlecy to absorption through tilc lympiatics. In the Nursery. In order to millimize tlle risks of iiifection during accidents in childlhood I kept a stock bottle of tinctture of iodine in the nursery in order to have it promptly applied to bruises, " gravel rashes," etc. I gave up carbolic fifteen years ago, because on returniing hom-ie I ofteni founld tilat there was no visible evidence of its having been applied to the required spot. I therefore stubstituted the tell-tale iodine, and was often amused to find thlat in such a case as that of a small scratchl upon the front of the knee, iodine liad been diligently applied half way up the tiigli and down nearly to the ankle-ritual run riot. During the last few years, when visiting many home and foreign clinics, I have been amlazed to find that those who know better thanl a nursemiaid do very much tlle same thing when they paint nmallogany colour the whole of the front of the abdomen and part of the chest in cases of appendectomy! I will now leave the subject of iodine and skin. and will give illustrations of cases in regiona surgery where I feel the use of iodine is indicated, either on account of preexisting sepsis, or because I feel that there is a possibility of infection in a clean wNvound-in such cases, for instance, as an accidental tear in a rtubber glove, or those in which during an operation uponi quiet gall-bladder and appendix troubles septic coniditions are found. Brain Surgery. In cases of abscess of the brain I always fill tlle cavity witlh tlle pure tiucture, and plug with gauze soaked in it. I may cite a case frolmi my friend Mr. Naunton Morgan, F.R.C.S.E., of a large abscess of the frontal lobe which would not lheal up satisfactorily until I removed the hernia cerebri witlh tlle cautery, and then dealt with the cavity by swabbilng it witlh iodine. Ccrebelltar Tumiour. In a case of a large tuibercullous tumour wlhich was removed successfully, the clotlh wlichl lhad been in contact with the skin came accidlentally in contact with the damoged cerebelltim, and in order to render the area less suitable for the growth of organisms, I painted freely witlh iodine. CcrCbral TlOmnour. Last yeear I removed successfully an extraordinia-y tumour-a large calcified parathelioma, or endotlhelioma, from the left lateral veiltricle. As I had removed the tumour witlh a£ naked finiger and tlhumb dipped in iodine, I afterwards gently swabbed the damaged area of the cortex cerebri wvith iodine. The wound healed up promptly. Abdom inl Surgery. In all cases of abscess dule to appendicitis I always anid inimediately apply iodine freely to the surfaces that have been exposed by incisioIl and mopping up of the pus; tlei result, in mv opinlionl, has beeni more satisfactory than it used to be before its introdtuction. Splappration of Rigj7ht (tanld Left Ovariian Cysts. A womanl, whlo hacd beeni very ill witlh paini anid pyrexia for over a week, had a fixed hard tumour occupying the. abdom-en from about 2 in. above tlle umbilicus downwards to the pelvis, wlhere on vaginal examination I found an immovable lhard vault. The operation had to be done expeditiously, alnd wllilst placinig the gauze roll above the tumour to isolate the intestines many ounces of offensivo pus welled otut tllrouiglh two ganigrenous patches oni tlle posterior surface of the cyst right into contact with tlhem. After mucll seriouis trouble andl difficulty in dissecting tllc left tumouir frolmi Douglas s pouch, uterus and bladder, I was compelled to leave tlhree long haemiiostatic clamlps urpo.i big vessels at tlle bottomn of Douglas's pouLcll. I thlen foun-d tllat tlhere existed a second small stuppurating. cyst in tlle righlt ovary, the size of my fist, attaclhed to tlzo appendix an(d ascendcling colon, and this also during its: reniloval buirst througlh oine anagrenous patch in thle cyst wall. As the peritoiletuimi hia(d beeni packed, only the pelvis and parietal peritoneumiii werec flooded; after careful aln( forcible mioppilng the whlole sturface alnd the intestines.were dealt witlh by pouring in about two ounces of iodine and swabbing. Tlie forcepj were remiioved on tlle second day, and after a little oozing through the opening left tlle case did well. Erogenital Surgery. In several cases of pyonephrosis, some large witlh publ taceouis miiaterial in the calyces, and extendilng down a dilated ureter, I lhave beeln able to get tlle damaged kidncy restored to function without a fistula in the loin. I anm much more colnservative as regards tlle relmloval of kidneys damaged by ttuberele or calculus than the majority of surlgeoins wlhose practice I have had the privilege of witnessing; I was led to adopt this conservative attitude by two incidents. Tlhe olne occurred in mny practice many years ago: a lady hlad a large pyonephrosis wvith creamy contenlts; whenl thle patient was convalescent with a drainl in her side, I tokld her hulsband that, in my opinion, it was advisable to remove the kidney. Afterwards he told hlis wrife of my view-s and wNe hladl a furthler consulltation. Thecy