TREATMENT 69 



absolute laws, but it is advisable to follow them 

 where it is desired to take advantage of every 

 helpful influence. They are most important 

 in subjects enfeebled from hard work or x)ri- 

 vation and when from any cause a clean opera- 

 tion and good after-care cannot be carried out. 



External applications such as liniments and 

 blisters we do not recommend. They only 

 complicate matters by irritating the skin and 

 encrusting it with dried excretions difficult to 

 remove in preparing the field for operation 

 later, and so far as we have been able to de- 

 termine they do not in any way influence the 

 course of the disease within. Occasional cases 

 abort in the cystic stage but this trend is spon- 

 taneous and is not hastened by local applica- 

 tions, and it is by no means certain that the 

 decrease in the size of the enlargement is per- 

 manent. Our observations indicate that at 

 least some of these rare cases recur and finally 

 burst to the surface. 



As regards the application of caustic chemi- 

 cal substances into the tracts we doubt if there 

 is any charlatanry, ancient, medieval or mod- 

 ern, that savors more of cruelty and malprac- 

 tice. The caustics — arsenic, copper sulphate, 

 lye, corrosive sublimate, caustic lime, zinc 

 clilorid, etc., after dissolving in the albuminous 

 secretions overflow the surface of the bodv. 



