tosis follicularis, was treated at the hospital with surprising results. The woman, aged fifty-six years, had been bedridden for many months, on account of the excessive development of the disease on the soles of the feet. Although submitted to varied and careful treatment, nothing gave relief except thorough and deep curetting under ether, which was done three or four times, but always with a recurrence of the disease. For some months before the X-Ray treatment she suffered so greatly from the deep, gnawing pain that morphine was continually required to secure any sleep. After two applications of the X-Rays the pain ceased; a moderate burning was induced and it took a week or more for the surfaces to heal, with appropriate treatment. The X-Rays were then applied less strongly, several times a week, and within a month she was up and around walking comfortably. She had in all twenty-five sittings of from five to fifteen minutes duration each.

A case of psoriasis in the hospital in a girl, aged twen ty years, had the X-Ray treatment to the back, with excellent results. The large patches disappeared after about eight treatments of five minutes each, twice weekly, the eruption on other parts, not thus treated, remaining active, even under good local treatment. Such cases are occasionally reported, but it is questionable if there is any real or permanent value in the treatment.

In a case of hyperidrosis of the palms in private prac tice, the controlling effect of the X-Ray was very notice able. The young lady, aged eighteen, had long had cold hands, whose palms were continually dripping with perspiration, and a single application of the X-Ray, for eight minutes, served to cause them to be perfectly dry for three days, when the trouble returned and the application was repeated a week later with similar effect. The same result has been reported by other observers, and in many cases this means will serve to check more or less permanently this trouble elsewhere also, as in the axillae.

Time will not permit further record of clinical facts, nor of mention of the many interesting features of this treatment which are accumulating on all sides. But enough has been said to show that in the X-Rays we have an agent of unusual and exceeding great value, the limits of which we have by no means yet reached. Much of the work still being done is, of course, yet experimental, for time enough has not elapsed since its practical introduction into practice either to prove what it is capable of in many directions or even to determine exactly the best method of its use; for, as yet, observers often differ a good deal in regard to many matters, such as the length of time of exposure and the frequency of its application, the distance of the tube from the affected part, the length of the spark gap, the speed or strength of the electrical current, whether from a coil or static machine, etc. Many of these items vary as to the case, and the individual idiosyncracy, and it is quite out of the question to enter upon them in the present writing.

It is important, however, to have this important therapeutic agent taken up intelligently by educated medical men, and not to have it left in the hands of quacks, nor even of medical men who may make the X-Ray more or less of a specialty. It is an agent capable of doing very much good when used exactly rightly, of doing harm when wrongly employed, or of being inefficient and useless under wrong circumstances.

Very little time is left to speak of the third topic, namely, high frequency currents of electricity in certain diseases of the skin, but although this is the most recent addition to this class of therapeutics, experience shows it to be of the utmost value in certain diseases of the skin.

It is difficult to define briefly just what is indicated by the term high frequency currents, the problems of the physics of electricity are so complicated; but it may suffice for our present purpose to state that the apparatus used is an attachment to a static machine, intro

duced by Dr. Piffard of New York, whereby an electrical discharge, termed hyper-static electricity, is produced, rich in violet rays, which passes through glass and is administered through a glass or carbon electrode, the two having quite different effects.

This I have used in my office in thirty cases, for twelve different complaints, and with almost unvarying satisfactory results. Brief mention may be made of some of them.

The carbon electrode is capable of producing superficial inflammation and destruction of tissue which is very valuable in certain cases which often prove troublesome, but for which more radical measures are hardly desirable or are refused. Thus, I have applied it to warts in five cases and the glass electrode in one case. The effect of the carbon electrode is to produce a superficial inflammation, sometimes with slight effusion of blood in the tissues, after which the mass dries down and in a few days falls off, leaving a slightly depressed spot, but no cicatrix, as the skin becomes about normal. This has served a very satisfactory purpose in several cases of warts on the hairy scalp and forehead. Four cases of xanthoma about the eye have been thus treated. A superficial crust falls off in a few days, leaving an improved surface, and a few applications cause healthy skin to replace the diseased tissue. I think this method will prove a valuable substitute for excision, which is often apt to give annoyance by the contraction of the eyelid which follows. In a case of molluscum fibrosum where there were literally thousands of tumors over the body, face, hands and arms, we are successfully removing some of those in exposed situations. Under two or three treatments they shrivel up after the crust has fallen. I have also used the carbon electrode successfully in the removal of small pigmentary moles, in three cases.

In one extensive case of nevus flammeus or port wine mother mark, the application of the carbon electrode ap

parently caused the disappearance of the trouble from the portion treated. The girl, aged fourteen, has left the city, to return in the fall, and I cannot now state positively the ultimate results. But, from what I know of the action of the current used thus, I expect to find the surface greatly benefited, though undoubtedly further applications will be needed to reach deeper blood vessels.

High frequency currents have been recommended, especially in France, in the treatment of that most obstinate complaint lupus erythematosus, and very gratifying results have been reported. I have had three cases under treatment, and while it is too early to state definite results, the disease is in all of them steadily diminishing. In these the glass electrode is generally used, from three to ten minutes, once a week, or oftener. High frequency currents, used with the glass electrode are also valuable in some of the inflammatory affections of the skin. They will allay itching, and, used on infiltrated patches cause their absorption. I have employed it in two cases recently, with beneficial results, but cannot yet speak positively in the matter from personal experience.

This method is also valuable in hastening the disappearance of obstinate acne lesions, although, of course, for the real treatment of the disease and permanent results careful internal treatment, medicinal, dietary, and hygienic is necessary. I have employed it satisfactorily in three cases.

In bringing this too lengthy and perhaps too personal paper to a close I can only say that I am as yet a novice and a student in the lines of work mentioned, but with each day's experience and study, I am more and more confirmed in the opinion that in light and electricity, (for they are but different forms of the same energy), we have means which, if properly used, may and should be of the very greatest service in the treatment of many

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forms of disease, both of the skin and other organs, and form a very great addition to our armamentarium in actual practice.

DISCUSSION.

Dr. McDonnell: The virtue of the methods brought before us is so great that we are deeply indebted to Dr. Bulkley, in the treatment of diseases of the skin by the X-Rays. From what the Doctor has said, it is evident that the extremely expensive treatment required for the Finsen Light is prohibitive to the ordinary patient. With regard to the X-Ray, the opposite can be said.

A member mentioned a case under treatment by XRays. The case is still under treatment. It is working fine there. In taking up the valuable part of these new discoveries, I think there is a tendency to overlook the older methods of treatment. We ought not to pin our faith to the new to the exclusion of the old and tried.

Dr. Bulkley: I would request the Doctor to tell about the patient mentioned in my paper.

The Doctor: The patient was wheeled in perfectly helpless and I have not seen her since. She is dancing now.

Dr. Bulkley: Well, if she is dancing, she must be cured.