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 pri- 
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, zine 
chlorid, ete., after dissolving in the albuminous 
secretions overflow the surface of the body, 
