He had up to the date of the latter extract operated upon forty-three cases of deformed noses and “in no case was there embolism, sloughing of the skin, or wandering of paraffin.” Paget, however, employs the paraffin in liquefied form, and allows cold water to trickle over the nose while the injection is molded into form. Of this later. Comstock says, “Paraffin must be used where it will be at all time above the body temperature,” and further that, “in selecting the melting temperature for surgical uses, it should be that from 106° to 107° F., the best for use in subcutaneous injections, for the reason that it gives a substance firm enough to hold very well its form, especially when confined by the surrounding tissue, and at the same time with a melting point out of the reach of the system at all times.” From this we are given to understand that he uses his preparation in cold form entirely when injecting, but of the melting point mentioned. The author can see no advantage in using any paraffins of low temperature melting points in liquid form. Here is the very factor of causing embolism reintroduced. Surely a liquid of any kind injected into a blood vessel will give cause for trouble, even if the temperature of the setting of such a paraffin be high or low. The employment of the paraffins of a melting point above 120° F. in cold form is difficult, if not impossible, even with the latest pattern of screw syringe which is quite true, but there is no need of using such paraffin nor any liquefied paraffin, since any such preparation of about the melting point of 110° F. will serve every purpose overcoming all the objections of the advocates of those using any other. If a vessel be injected and filled with any paraffin preparation there is danger of phlebitis and thrombosis; the only possible way to overcome it is not to puncture the vessel. While a preparation injected cold can be more easily governed from without by digital pressure or guidance, what can be said for a hot seething preparation introduced under great pressure? Furthermore, when paraffin is injected in liquid form, especially when so rendered by a temperature necessarily even higher than the actual melting point, there is danger of searing the entire site intended for injection—a condition inducive to no good and a burning of the skin where the necessary superheated needle enters it, causing a punctate scar, more or less painful during the time required to heal the wound. With the later knowledge that small amounts should be injected, and that such injections should be repeated, it being known that such method facilitates the production of new connective tissue, may we not draw the conclusion that the result obtained by the injection depends not upon the injection _per se_, but the resultant of that injection—namely, tissue production, and that this tissue production is the outcome of a stimulus in the form of that injection?