which are irritating and to secure the effect of the more penetrating rays which reach the deeper tissues.

The length of exposures is usually from twenty to eighty minutes without screens, and from three to twenty-four hours with screens or when inserted into a tumor.

Cases Treated: My own experience has been limited to the use of ten mg. of pure radium bromide of 1,500,000 units activity in a sealed glass tube. The best results have been obtained in cases of epitheliomas of the skin. These have varied in size from 14 inch to 2 inches in diameter, some very superficial and others involving the deper tissues. They had existed varying lengths of time from one to twenty-three years. The average duration in the cured cases was eight years. Some of the cases had been under various forms of treatment such as caustics, plasters, X-rays and operations. The results in twenty cases were twelve cured, six temporarily improved, two unimproved. Of the cured cases, the number of treatments varied from one to sixteen, the average number of treatments were six. The usual duration of treatment was from three-fourths to one hour. The cases which had not had previous treatment of any kind responded more quickly to radium treatment, but some of the cured cases had had almost every other form of treatment.

Other cases treated and cured were a few keloids, warts, chronic eczemas, angiomia, one epulis of the sup. maxilla was cured; three hairy moles gave unsatisfactory results; three inoperable cancers of the breast were treated without any marked or lasting benefit; one inoperable sarcoma of the orbit, no result; one persistent trifacial neuralgia, doubtful result; two exopthalmic goitres, doubtful result; one cancer of the tongue, is now under treatment and has proved very interesting. When the patient first came referred by Dr. J. H. Maxwell, of Greenville, S. C., I advised an operation. The cancer had been there about five or six months and was rapid

ly growing. It was ovoid in shape, about two by four cm., on the right inferior surface of the tongue and had just crossed the median raphe. He was given one and one-half to two hours exposures on two successive days and then an interval of two weeks was allowed. After about six treatments there was some inflammatory reaction; then the ulcer began to heal and the edges to contract so that the cancer was now limited to the right side of the tongue only and was smaller. I again advised operation but he still refused. Since that time the growth has remained about stationary. At least we have stopped a rapidly growing cancer and caused it to contract at the edges. What the future will be I dare not say.

Conclusions: (1.) Radium is the best form of treatment for superficial epitheliomas, keloids and naevus. (2.) It succeeds where the X-rays and other forms of treatment have failed.

(3.) It is painless, easily applied, free from complications and leaves little or no scar.

31 Century Building.

DISCUSSION-PAPERS OF DR. OERTEL AND DR. HODGSON

Dr. R. R. Kime, Atlanta: I consider the two papers just read as rather too important to go without any discussion. They are full of interest to a great many of us. So far the cause of malignant disease is unknown; this is a question for the future to decide. There is probably an invasion of certain tissues by cell infiltration. There is a possibility that by the use of the X-ray or radium that absorption takes place and cell infiltration may not be stimulated. However, this is a question for the future to determine. Hithertofore it has been pointed out that, wherever possible, the growth should be removed either with the knife or by means of caustics. Then it was advised that after removal of all of the invaded tissues possible, other methods of treatment should

be carried out, such as suggested. Now it is pointed out that there is no possibility that by the use of the X-ray or radium that metastases may not take place in other organs of the body.

There is a wide range of usefulness for these means of treating malignant growth which cannot be removed by the knife or by caustics there are cases in which it is imposible to remove malignant growth by the knife or caustics; in such cases the X-ray or radium answers a good purpose.

There is another question that comes up regarding the depth or the penetration of radium. This, of course, is very important in growths that are deep-seated.

Dr. T. E. Oertel, (closing): It seems to me that, even with my limited experience with radium, we can treat growths about the face, particularly about the eyes, successfully, particularly epitheliomas, and without the danger of the disfiguring contractions. I think this is one of the chief advances. All of us have seen the horrible results of operations about the face for epithelomas; we have seen the hideous contractions about the eyelids. Dr. Abbe, of New York, has reported one case of sarcoma of the lower eyelid which was cured by the employment of radium and with an absolute return to the normal, there resulting no scarring and no contraction.

Dr. F. G. Hodgson, (closing): I should like to add one more word and state that patients treated by radium do better if they are not subjected to other forms of treatment. Even a very small growth if cut out and then treated with radium will look bad and scar and contract; this would not happen if radium was the only treatment employed. When a growth like epithelioma is treated with radium, the cancer cells disappear and there is soon a return to the normal appearance of the skin. But if

the knife or caustics be used, and the radium used afterwards, there will be much scarring. If you have to deal with a small epithelioma, superficial in character, one that is easy to get at, radium gives the best results, with less contraction and less scarring; it is better than any other form of treatment in such cases.

PRESIDENT'S ANNUAL ADDRESS.

Members of the Medical Association of Georgia, Ladies and

Gentlemen:

There are emotions of the soul which no artist hand can paint nor language fittingly express. Here in this assembly of doctors of the Empire State of the South, in the beautiful classic city of Athens, which brings us memories of such illustrious men as Dr. Crawford W. Long, Henry W. Grady, Ben Hill, the Cobbs, and others of historical renown, here in such atmosphere where the gentle winds murmur forever among the unbrageous branches of the neighboring oaks, is a scene that fills my heart with emotions that I cannot express. Confucius has said that words are the voice of the heart, but I feel that words are too cold and phrases too empty for me to attempt to express my appreciation for the honor conferred upon me a year ago when I was made president of this association.

To be president of the Medical Association of Georgia, is an honor of which any doctor might well feel proud, and since my connection with the association this distinction has been the goal of my professional ambition. I have now attained at an early period of life what I regard as the highest honor within the gift of my professional brethern.

In assuming the duties of the office I found that my predecessors had aroused considerable interest and enthusiasm in society work and had affected a very thorough organization of the profession in our state. They, together with the efficient board of councilors have rendered invaluable service, the effect of which will live long after they are gone. The most important work for the present administration was to improve the character of the work done by the county, district and state societies and make some changes in our medical laws. To