By G. BETTON MASSEY, M. D., PHILADELPHIA.

THE first requisite in the treatment of malignant diseases of any kind is immediate action. A case of bubonic plague introduced into a large city is not more dangerous to the health of the community than is the first small appearance of a cancerous nodule to the general health of the individual affected. The certainty that the isolated infection in the nodule will give rise to daughter growths elsewhere in the body is so great that the common habit of procrastination on the part of patients can only mean that they have absorbed from the medical profession either a doubt of any method being efficacious in the disease, or the equally wrong and hopeless view that cancer is the "pointing" of a general constitutional affection. The onus in either case is laid at the door of physicians, and it is high time that we fully awaken to the issues involved and make it clear to ourselves as well as to our patients that this disease, whether parasitic or not, is strictly local at its inception and capable of eradication in this stage, and that the second stage of systemic invasion may occur at any moment after the implantation of the local disease. That the general invasion is usually postponed for weeks or months, in accordance with the individual virulence of the germ or cell, has apparently not stimulated our patients to immediate action in utilizing this fortunate interval but rather caused further delays, and it is to be feared that many physicians when consulted fail to realize the importance of this brief respite from actual metastasis, and the hopelessness of the case only after this extension has taken place. It is too true that the interval between the appearance of the growth in a recognizable form and its internal dissemination may be so slight as to thwart the efforts of the most energetic, but what can be said in extenuation of the neglect that permits weeks or even months to elapse between recognition and action!

As to the method of eradication of an accessible growth seen in this curable, or so-called operable, stage, there can be no doubt in the mind of anyone who has witnessed the method of immediate destruction and sterilization by the massive cataphoric diffusion of mercury, introduced by the writer. The knife and curet have unquestionably the dangerous property of implanting the germs of the disease in the cut edges of the wound, unless, indeed, a far distant amputation is practicable. By the cataphoric method, applied under general anesthesia usually, the nascent oxychlorids of mercury and zinc are dissolved from electrodes thrust within the growth, causing an immediate, sterile necrosis of the growth proper and a sufficient dispersion of the germicidal salts beyond its apparent limits to sterilize the surrounding tissues for an inch or more. All morbid cells are killed in situ, those contained in the growth coming away as an inodorous slough, while the cells in the sterilized zone about the growth are absorbed as debris. When it is understood that this total destruction can be accomplished in from one-half to two hours, with practicly no after discomfort to the patient, it is evident that we are possessed of so ideal a method of eradication of this dangerous guest that we are no longer warranted in delaying a day in its accomplishment.

The choice between this method and .r-radiation is a question of much greater importance in growths classed as inoperable. As a general rule, it may be said that a combination of the two methods is often here desirable, the cataphoric destruction being carried as far as possible, if it cannot be made to reach the furthest limits, followed by radiation as soon as the slough comes away, which happens in from seven to twenty-one days after the application. By this simultaneous attack, growths that are most extensive may be successfully coped with, the preliminary destruction and aseptic removal of the major portion by the cataphoric operation opening a way for deeper penetration of the rays, and at the same time preventing the absorption of toxins during the radiation of large growths.

When the growth is not so accessible, as in the case of those situated in the nose, mouth, vagina, uterus or rectum, the cataphoric method will usually have to be depended on alone, whether the case is classified as operable or inoperable.

A DAILY STUDY OF FOODS PRODUCING OR NOT PRODUCING CASTS, FATTY EPITHELIA, AND ALBUMIN IN URINE.

BY EPHRAIM CUTTER, M. D., NEW YORK.

[CONTINUED FROM APRIL NUMBER.]

PLEASE Compare the urine with the preceding breakfast (B.), lunch L.), dinner (D.).

February 1.-(B.): Beefsteak; codfish; coffee and cream; baked potato; corn bread; butter.

(L.): Roast beef; potato salad; water; Boston brown bread; butter; gravy.

(D.): Oyster roast; crackers; cheese; water; dates; English wal

nuts.

February 2.-(U.): Casts, both kinds; filamentous and protoplasmic catarrhs; bile.

(B.): Cold ham; coffee and cream; Boston brown bread; mince pie; cheese.

(L.): Consomme soup; turkey, dark meat; tea; mince pie; cheese. (D.): Roast oysters; whole wheat (dextrosed*) and cream; English walnuts; dates; cheese.

February 3-(U.): Almost normal, save color.

(B.): Mutton chops; fried eggs; coffee and cream; baked potato; corn bread and butter; water.

(L.) Beefsteak; baked potato; coffee and cream; water; whole wheat dextrosed and cream.

(D.): Roast beef; boiled potato; butter; coffee and cream; apple pie. February 4-(U.): Normal.

(B.) Hamburg steak; coffee and cream; beefsteak; baked potato; whole wheat mush dextrosed and cream.

(L.): Hamburg steak; coffee and cream; whole wheat mush dextrosed and cream; water.

(D.): Roast veal; baked potato; apple pie; coffee and cream. February 5-(U.): Almost normal, save bile.

(B.) Whole wheat mush dextrosed and cream; Hamburg steak; baked potato; horse-radish; cream.

(L.) Hamburg steak; coffee; baked potato; butter; Indian pudding.

(D.): Macaroni soup; roast mutton; baked potato; tea; beets;

cream.

February 6.-(U.): Normal, save amyloid.

(B.): Hamburg steak; baked potato; coffee and cream; horse-radish; butter; whole wheat mush dextrosed and cream; Baldwin apple pie.

(L.) Hamburg steak; whole wheat mush dextrosed and cream; coffee; baked potato.

(D.): New England boiled dinner; water.

February 7-(U.): Almost normal.

(B.) Hamburg steak; coffee and cream; whole wheat mush dex

trosed and butter and salt.

(L.) Hamburg steak; coffee and cream; baked potato.

(D.): Soft clam chowder; baked codfish; coffee and cream; boiled onions; whole wheat mush dextrosed and cream.

February 8.-(U.): Almost normal.

(B.): Hamburg steak; coffee and cream; baked potato; butter. (L.): Same as breakfast.

(D.): Pea soup; boiled corned shoulder of pork; boiled cabbage; boiled potato; mince pie and cheese; water.

=

* Dextrosed glucosed = to a sugar that perfectly produces red oxide of copper in the Fehling test. No malt, no chemicals. Process of the author.

February 9.-(U.): Albumin.

(B.) Hamburg steak; coffee; whole wheat mush dextrosed and

cream.

(L.): Roast turkey, dark meat; gravy; baked potato; coffee; tomato; mince pie.

(D.): Cold corned shoulder of pork; water; cream; baked potato; citron preserve; butter.

February 10.-(U.): Normal, save amyloid.

(B.) Hamburg steak; whole wheat mush dextrosed and cream; horse-radish; butter; coffee and cream.

(L.) Hamburg steak; whole wheat mush dextrosed and cream; coffee.

(D.): Soup; roast beef; boiled potato; Lima beans; dates; mince pie and cheese; milk and water.

February 11-(U.): Normal, save bile.

(B.): Hamburg steak; beefsteak; coffee; whole wheat mush dextrosed and cream.

(L.) Soup; two whites of eggs; beef stew; boiled potato; coffee; water; orange pudding.

(D.): Carrot soup; roast beef; green peas.

February 12.—(U.): Filamentous catarrh and kidney casts.

(B.): Banana; Hamburg steak; baked potato; coffee and whole wheat mush dextrosed, cream for both.

(L.): Hamburg steak; baked potato; whole wheat mush dextrosed and cream; coffee.

(D.): Chicken soup; roast mutton; milk; water; beets; boiled potato; cheese; crackers.

February 13-(U.): Almost normal.

(B.) Hamburg steak; whole wheat mush dextrosed and cream; coffee.

(L.) Same as breakfast, with cheese.

(D.): Vegetable soup; roast beef; boiled potato; string beans; whole wheat mush dextrosed and cream; coffee; cheese; dates; white of egg.

February 14-(U.): Normal, save bile.

(B.) Hamburg steak; coffee; whole wheat mush dextrosed and cream; baked potato; butter.

(L.): Same as breakfast, with white of egg; no wheat mush.

(D.): Veal cutlet; baked potato; cranberry sauce; onions; custard pie; water.

February 15.-(U.): Normal, save bile.

(B.): Hamburg steak; coffee and cream; whole wheat mush dextrosed and butter.

(L.): Same as breakfast, plus one-half baked potato.

(D.): Roast beef; baked potato; mince pie; cheese; turnip; water. February 16.-(U.): Same as February 15.

(B.): Same as yesterday.

(L.) Preserved peach; cold ham and mutton; mustard; hashed potato; water; whole wheat mush dextrosed and cream.

(D.): Soup; roast beef; celery; boiled potato; string beans; turnip; mince pie; cheese; dates.

February 17-(U.): Same as yesterday.

(B.): Hamburg steak; baked potato; coffee and cream; whole wheat mush dextrosed and cream.

(L.): Same as breakfast.

(D.): New England boiled dinner, with white of egg; cabbage; carrot; turnip; beet; water.

February 18.-(U.): Normal.

(B. and L.): Hamburg steak; baked potato; butter; coffee and

cream.

(D.): Soup; roast beef; whole wheat dextrosed and cream; water; mince pie; nuts and raisins (a family reunion). Later a family meal of spiritual kingdom food, that is, music-much of it original.

February 19.-(U.): Normal.

(B.): Rump steak (beef); coffee and cream; whole wheat dextrosed and cream.

(L.) Hamburg steak; coffee and cream; whole wheat mush dextrosed and cream.

(D.): Chicken soup; roast beef; boiled potato; green peas; beet; graham bread; butter; coffee and cream; white of egg.

February 20.-(U.): Normal.

(B.) Hamburg steak; coffee and cream; whole wheat mush dextrosed and cream; pickles.

(L.): Chicken soup; cold roast beef; codfish; Indian meal griddle cakes; water.

(D.): Soup; roast pork chine; boiled potato; Lima beans; cranberry sauce; water.

February 21-(U.): Normal.

(B.): Hamburg steak; butter; whole wheat mush dextrosed and cream; coffee and cream; pickles.

(L.) Hamburg steak; whole wheat mush dextrosed and cream; coffee; pickles.

(D.) Clam (soft) chowder; lettuce with vinegar; roast beef; plum pudding; coffee and cream separate; graham bread and butter. February 22.-(U.): Normal.

(B.): Same as breakfast February 21. (L.): Ditto.

Intermediate.-Dates.

(D.) Macaroni soup; roast beef; cabbage; potato; turnip, all boiled; water.

February 23.-(U.): Abundant true and false casts; bile; some filamentous catarrh and fatty epithelia.

(B.): Hamburg steak; whole wheat mush dextrosed; coffee.

(L.) Cold roast pork; baked potato; apple pie; butter; water; milk.

(D.): Roast lamb; string beans; baked potato; cranberry sauce; coffee; dates.