EPITHELIOMA.—Although epithelioma of the skin is included with cancer in the Mortality Tables of the United States and elsewhere, I do not purpose to admit it in connection with the results of treatment of cancer, for several reasons. First, Because cutaneous epithelioma occasions but a very small proportion of the deaths from cancer, something over three per cent. Second, Because its cause and treatment are almost entirely local, and so it does not relate greatly to our general inquiry as to the internal or constitutional cause and treatment of real cancer. Third, Because dietary and medicinal treatment seem to have relatively little, if any, effect on cutaneous epithelioma, except in the later stages, where the disease has caused great ravages, and lastly, Because if the proper treatment of cutaneous epithelioma is begun early and carried out faithfully it need never, or exceedingly seldom, acquire a severity such as is often depicted by overzealous surgeons who advocate only the knife. In regard to epithelioma on the skin and also on the tongue, lip, and oral cavity, however, I want to give you one word of caution, and that is in regard to the use of nitrate of silver. I have seen so many epitheliomatous lesions in these regions which have been goaded on to a severe degree of ulceration by the injudicious and meddlesome “touching up” of the same with nitrate of silver, that I would make it an axiom to never use this superficial caustic at any time in connection with anything which may possibly be epithelioma. I would almost consider it criminal to do so. On another occasion I may take up the subject of epithelioma very fully, but already I have shown you many interesting cases, demonstrating how it can be cured by intelligent and faithful treatment without surgical operation. Some of you may recall the enormous ulcerating epithelioma on the left ear of a man of about fifty, who showed himself repeatedly after the disease had been entirely cured by the thorium paste, which you have often seen me use. You may remember that the upper portion of the pinna was gone, but presented a thin, delicate cicatricial surface, freely movable; the last time he was here was fully two years after it had been entirely well. It is not worth while to attempt to analyze here the 685 cases of epithelioma mentioned, many of which were small and very superficial, and easily cured. There were, however, many cases which were originally classed as epithelioma which sooner or later, either with or without a previous surgical operation, took on such a malignant action, with a destruction of tissue, as would at once class them with carcinoma. In reality, as you know, carcinoma is but an aggravated or malignant new growth of epithelial cells, from the skin or glandular organs, infiltrating the surrounding tissue; while sarcoma is a somewhat similar malignant proliferation of connective tissue cells.