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don Hospital in 1909 and described its Order Generic Viagra Uk use in The Lancet. When first used it was ordinarily applied not longer than about ten seconds on a part, but now we often use twenty, thirty, or more seconds and under considerable pressure. This causes some pain in the part which becomes numb and hard, and is found, upon removal of the block, to be coated with a thin white, shrunken coat which soon becomes darker. There is considerable anaemia of the part. \\'ithin a hour or so a bleb may form even with light pressure and brief exposure ; this is replaced, later by a crust which falls oft in ten days. If the vesicle or the bleb is near the ej'e it often causes much accumulation of lymph in the tissues and the swelling hides the eyeballs. It is well to protect one's own fingers with gauze or asbestos in handling the bit of "snow." We should not treat large areas at one sitting. Sometimes a petrolatum dressing is applied to the part after it has been treated, or a dusting powder containing bismuth. A few days after an exposure there may be left no evidence whatever of the disease nor of the treat- ment, if it is light, other than the cure of the case. At other times a clean, smooth, white scar may be seen after tlie crust has disappeared. The temperature of the solid stick is — 79° C, and may be made lower if the solid is dipped in ether. .■\ block oi the snow is readily prepared and may be kept about an hour for use on patients. Patterson advises against using it for a long period of time on an alcoholic or on diabetics, those suffering from arteriosclerosis, and on lesions just over Order Generic Viagra Uk bony promi- nences. In treating a nsevus, c. g., on the forehead, Order Generic Viagra Uk with much pressure, from fifteen to twenty seconds generally suffice to cause bleaching and fading of the lesion, whereas forty seconds may cause a gan- grenous spot needing treatment. The paramount action of the "snow" is destructive and its action must be guarded, just as must the action of x rays. Order Generic Viagra Uk In repwrting cases photographs should be taken before treatment and after when the cases them- selves cannot be shown. This has been done in our practice at the hospital in different lines, but often one hastens to the treatment of a case possibly on a bad day and the preliminary picture is neglected ; or in other cases tlie neglect is in taking the final photograph. In addition to simple cases of warts (verrucje), lupus, naivus. favus. etc., that have been success- fully treated, there are a few Order Generic Viagra Uk cases of interest the notes of which I wish to quote. Tattoo marks, powder marks, possibly ringworm anr! tnichnma. may later show some advance in treatment and clear up difficult problems by judicious use Order Generic Viagra Uk of treat- ments along these lines. Permit me to cite a few cases that I have treated recently by this method. Case I. J. W., a carpenter, had been troubled with a iluck crustaceoui lesion on the right side of his face for some months; he was Order Generic Viagra Uk told this uas cancer and was ad- vised to take X ray treatment ; ho took one treatment and without any results. He was then given the freezing mixture for about twenty seconds on .August 21, 1910, and was much improved; two days later he was given a sec- ond exposure and diachylon ointment dressing applied. .\ few days later you could not tell iff)on which side the senile keratosis had existed. Case II. R. B. This was a similar case but of some years' duration, and the lesion resembled a small patch oi lupus vulgaris. The patient likewise feared malignancy. He was cured completely in three treatments and has re- Order Generic Viagra Uk mained so for many weeks. C.\se hi. E. M. B. This was a case similar to Case n as regards rapid improvement. The lesion was ni the nature of a mole and was Order Generic Viagra Uk cured completely by one treat- ment. C.\SE IV. M. R., a woman, a case similar to the pre- cedmg, cured by two treatments. She also had a horny growth on the back of the right hand, the top Order Generic Viagra Uk pan of which was first e.xcised and then the base treated ; this re- quired three or four treatments and she went out of the hospital before completely cured. C.-\SE V. J. K. ; a case diagnosticated as luptis, about cured Order Generic Viagra Uk after Order Generic Viagra Uk two applications. Case VI. J. W. ; had part of the right side of his face removed for rodent ulcer ; he was also given about sev- enteen or more x ray exposures. Recurrence took place and he was operated upon again. He was now given a cancer serum made from the ground up cells of cancer mass in salt solution, and after this nothing remained but some excessive granulations ; these were treated by tlu- ■'snow" method, and the patient is apparently cured. Cases VII, VIII, IX and X. These were also cases of superficial malignancy treated in addition with .k rays and touched with such drugs as silver Order Generic Viagra Uk nitrate, carbolic acid, camphor, collodion, etc. These patients, too, have been cured or nearly so, and for some time. It has been observed that certain cases are more amenable to this form of treatment than are others. Rodent ulceration seems to be not benefited or only in connection with other means. The saiue may bo said of hard horns. I have not had sufficient experience yet with ntevi ttor with lupus erythematosus to corroborate the extraordinary results obtained, but have seen .some- thing of these results. Recently Harman, of London, has been using from fifteen to thirty second exposures of the mate- rial on cases of trachoma. Hawkin has shown its destructive influence on microorganisms. Out of 900 cases of- capillary nasvi one author cites ninetv per cent, of cures. There are no doubt other classes of cases that may be benefited by the a]ipli- cations. I expect to try it also on keloids. Order Generic Viagra Uk Carbon dioxide is much cheaper than radium, it is easier to control than liquid air, it is more prompt in its action on certain lesions than the x rays; it> action can be better regulated than many other methods. The large tanks are preferable ; they are strong and may generally be borrowed; they cost about twenty-five dollars, and about two dollar- to recharge them. Portable tubes may also be used for office practice.