BY C. GURNEE FELLOWS, M. D., CHICAGO.

Case I.—Early in 1899, Mrs. H. B., age forty-nine, presented herself for an opinion as to her condition. She had been hoarse for three or four weeks, and had a little inconvenience in swallowing, with no cough, but she complained of ordinary sore throat such as would follow an everyday cold. The main symptom was an excessive amount of mucus from the nose, nasopharynx, and pharynx.

Examination revealed a large pharyngeal ulcer on the left side, with enlarged cervical glands on the same side, and my suspicions were aroused as to its malignancy. Upon expressing such a fear the patient admitted that she had been examined by a surgeon who likewise had suspected carcinoma and advised its removal. She absolutely refused to think of operation at anybody’s hands, and insisted upon my giving it the best treatment possible.

I cleansed it with the usual antiseptic solutions, and applied orthoform and other well-known and everyday methods for a week or two with a fair amount of relief, but the ulcer continuing, I applied specific treatment in the hope of clearing up the diagnosis, and, much to my delight as well as to the patient’s comfort, the ulcer healed, the induration disappeared and the patient was, to all intents and purposes, well. After a number of weeks the external glands even diminished in size, so that I rather felt that the diagnosis of cancer was wrong and that it must be specific in character.

The patient ceased her visits, but returned in a few more weeks with a condition as at first, but upon the opposite side of the pharynx. Same treatment and everything else I could suggest did absolutely nothing for her relief, and I felt that the diagnosis this time must be carcinoma, but she refused even to have a small section taken for the purpose of diagnosis. Consultation agreed with me as to the malignancy of the growth, but operation was refused. She died in another month, practically from starvation.

I report this case after having read the article by A. Worrall Palmer upon cancer of the larynx, in the January number of this journal, because in the prelude, this method of diagnosis, and the application of this specific mixed treatment is advised, and because in this case it was followed by apparently successful results with what seemed to be an entire cure of the case, and therefore a clearing up of the diagnosis, but which, on the other hand, was followed by a return of the same condition, but upon the other side of the throat. The second point in the case is the great relief of all symptoms following the iodide of potash and merc. administered internally, and the administration of kali bi. and arsen., which most certainly had in the early part of the disease a very satisfactory effect. I believe that this case was cancer from the first, but that, contrary to expectations, it yielded beautifully to internal treatment.

Case II.—Mrs. M. E. C, age fifty-six, presented herself with a sensation of swelling in the throat accompanied by stinging pain, and with a history of from one to a dozen attacks of suffocation each twenty-four hours, much worse at night; otherwise no soreness of the throat or special sickness preceding these attacks, but they have been fairly constant for a year. She had become suspicious of the trouble being cancer, and, after having had some months of treatment from her family physician, she was more impressed with the fact than ever.

Examination revealed nothing in the way of foreign growth, but very much enlarged varicose veins at the base of the tongue, with a granular pharynx. Prognosis was favorable and the treatment as follows:

Glycerole of iodine to the pharynx and base of tongue, following cleansing and antiseptic solutions; galvano-cautery destroying the largest of the blood vessels, and moschus 3x internally. A complete cure resulted in less than thirty days; complete cessation of all attacks, which, of course, proved the diagnosis to be other than any malignant trouble, and, although the local treatment was probably efficacious, I believe that much of the trouble was of a neurotic type, incident to the climacteric, and that moschus deserves a good deal of credit for the result.