usually removed and replaced daily. It prevents both the loss of movement, which usually occurs, and the muscular atrophy, which is the natural result of absolute rest and immobility. The prevention of exudates, or their early absorption, may be mentioned as other valuable results of passive exercise in this class of cases.

In conclusion, I wish to say that every physician should know something of the method of physical exercise, and should avoid vague expressions, such as "out of door life," "muscular exercise," and so on, when consulted as to the propriety of exercise in an individual case. Give your patients the advice in regard to physical exercise that they expect to receive from you, and the danger will be forever removed that they fall into the hands of some preposterous humbug

METHYLEN BLUE IN THE TREATMENT OF

CANCER.

BY HENRY R. SLACK, M.D., LAGRANGE.

Cancer has the whole world for its field, and destroys all sorts and conditions of men; while more common among the old, the young are not entirely exempt, as Osler reports six cases of cancer of the stomach in the first three decades of life.

The wise old father of medicine, Hippocrates, writing about 400 B. C., has this to say of the treatment of cancer: "The deep-seated forms are best untreated, for if treated the patient soon dies; otherwise he might hold on for a long time." Inaccessible cancer is two and a half times more frequent than accessible; therefore, any treatment that gives reasonable assurance of prolonging life and not shortening it, as was the case in the days of Hippocrates, is welcomed by the physician, and is a boon to suffering humanity. Especially is this true when the administration is as simple as the one that I will present today.

Ten years since I read a paper before this Association entitled "Blue Pyoktinin in the Treatment of Inoperable Malignant Growths." This paper was published in the Journal of the American Medical Association, June 27, 1897, and was pretty widely commented on. Shortly after this the X-ray began to be applied in the treatment of cancer with such success that all other methods, except surgical, were completely eclipsed by this new and wonderful fight that possessed such marked therapeutic power.

The novelty of Roentgenization had not worn off before the discovery of the new element, radium, added a still more mysterious weapon to our therapeutic armamentarium. The extravagant claims of the users from the radiations of this new element have not been borne out by the experience of careful clinicians, and we are again turning our attention to some of the older methods. Even Dr. Willy Meyer, of New York, who first introduced blue pyoktanin in the treatment of cancer in America, seemed to have been carried away by the new agents, but net so with that sturdy old nestor in therapeutics, Dr. Abraham Jacobi. He has kept quietly using in his immense practice methylthionin hydrochlorid, as it is now called, or methylen blue, in the treatment of inoperable malignant growths, until he has now treated 150 cases, as reported at last meeting of American Medical Association in Boston.

Herbert Spencer says that our judgment is based on our personal experience. My personal experience with methylen blue has been very satisfactory, though I have had to abandon the hope, expressed in my paper ten years ago, of effecting a cure by its use alone, still the benefits derived are so pronounced that I feel justified in continuing its administration in such cases.

I have found the treatment then used quite painful, so have abandoned the technique suggested by Von Mosetig and Willy Meyer of parenchymatous injection of a two per cent. aqueous solution, for Jacobi's of simple administration by mouth. I give a tablet containing methylen blue, 2 grs., extract of belladona, 4 gr., each, after each meal. If there is an ulcerating surface accessible, I dust it with a four per cent. or five per cent. powder, or use a two per cent. injection daily. I also use the X-ray if on the surface, breast, or face, as I have seen a number of

cures follow the careful, judicious application of Roentgenization.

I reported five cases in my paper and have since treated. twenty-nine, but will give only three, as they are fairly representative.

Case 17-Mrs. M. E. B., age fifty-six, widow, had nine children; three miscarriages. Complains of large and painful lump in right breast and under arm. Family history negative. Personal history, had usual diseases of childhood; menstruation, thirteen years, regular, and passed the climacteric in forty-eight years without incident. Has had typhoid fever, pneumonia, and malaria. Health not good for last seven years. Present trouble started in October, 1899, with lump in right breast, but did not give much pain or grow rapidly until January, 1903. Appetite good and bowels regular.

Examination-Fairly-nourished woman, heart and lungs negative, has tumor in right breast as large as goose egg, adherent and nipple retracted, axillary glands indurated. Case went to St. Joseph's, Atlanta, for operation, but surgeon said was inoperable carcinoma.

Treated with X-ray for ten weeks. The indurations in axilla entirely disappeared, and tumor in breast reduced to size of chestnut. She then left me, and I did not see her any more until February 1, 1904. She had been treated by a local physician with X-ray, and had bad burns, which had to be healed before treatment could be resumed. After six weeks she was in fine condition.

October 25, 1906, she returned very feeble and cachectic, with a foul ulcer above the nipple over an inch in diameter, and also two ulcers in the axilla. The arm was very painful, much swollen, and could not use it at all. This time we used the methylen blue tablets internally and applied the powder to the ulcers daily, as well as X

ray to it occasionally. Her improvement was marked, and she is now free from pain and doing nicely, though not cured.

Case 21—J. W. M., age forty-six, male, farmer. Complains of sore on lower lid of left eye. Family history: Father had a similar place. Personal history: Has usual diseases of childhood; denies venereal disease; general health good. Present trouble started with crust and scab over two years ago, and had gradually grown larger until now it is larger than a dime. Appetite good and bowels constipated.

Examination-Well-nourished man, heart and lungs negative. Has epithelioma size of dime under left eye. Treated with X-ray three times a week for six weeks and ulcer reduced in size to a grain of wheat and gave no trouble, but never did heal or disappear until used methylen blue internally and applied the powder to surface. Has now been well several months.

Case 26.-L. J. N., age forty-six, female, married, one child. First consulted me thirteen years ago for dysmnorrhea and sterility. Found stenosed cervix. Dilated, and ten months afterwards she gave birth to a fine girl. Did not see her again until nearly five years later. Was then complaining. of pain in back, leucorrhea, etc. Examination showed lacerated cervix, with ulceration.

January, 1907, her husband said she was "Mighty bad off, sick in bed, suffers all the time and bleeds a great deal."

Dr. McCall, my assistant, called to see her and found exfoliating carcinoma of uterus, involving the vaginal walls and inoperable. He gave methylen blue and an injection of a two per cent. solution daily. She is now up, free from pain, and able to do her housework.

I have selected these three cases, not because they have