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Tincture of nux vomica in combination with one of the mineral acids also proves helpful in chronic cases. .Surgical intervention is necessary in that type of cases in which the condition is secondary to abscess formations, malignant and other growths. -Suite 602. Pkrrtx I'uilding. USES OF THE -COLD CAUTERY," ESPECI.\LLV IN DERMATOLOGY.* By Leonard D. Frescoln, A. M., M. D., Philadelphia, Assistant Chief Resident Physician, Philadelphia Gene-.al Hospital; Fellow of the College of Physicians. As we Iviiow the term, "cautery" has been Viagra Buy In Canada used to denote an appliance for giving a high degree of heat to a part so as to parch that part, or cut it. We can, therefore, apply a red heat and bake super- ficial parts, or, with a higher degree, use a white light, high enough to penetrate deeply and quickly, but not melt platinum. The control of hsemorrhage by means of cauterizing has Viagra Buy In Canada been in use many decades. Disturbances in the cells and blood cells of livmg tissues are often manifestations of different degrees of temperature. It is true, some disturbances of cells are galvanic changes. Now, when we have much disturbance, as in acute local inflammations, reduction of temperature may be accomplished by using varying degrees of cold. Likewise artificial heat is used to affect tissues locally when indicated. And so in the practice of medicine there is made use of the hot poultice, hot fomentation, the Leiter ice coil, the ice cap and ice collar, hot water bottle, fly blister, Paquelin cautery, counterirritation, etc. We also use the galvanocautery, the galvanic bat- tery, the X rays, Finsen light, radium, and thera- peutic bath, to effect cell changes. Taking up the question of local temperature, just as gradual or rapid alterations and destruction take place under different degrees of heat (above body temperature), so with cold; and we have a Viagra Buy In Canada rather rapid method of freezing now in practical use in carbon dioxide "snow." This is collected by having the gas escape from under pressure into a chamois bag that has been wrapped over a ruler for con- venience. The valve of the iron container should be lower than the rest. The gas is heard to crackle Viagra Buy In Canada and becomes deposited in Viagra Buy In Canada a few seconds and may be moulded into the form of a cone or packed in a pill box. This substance rapidly draws heat from its sur- roundings and gradually melts away ; it does this on the skin rapidly enough to cause vesication, just like extreme frost bite, but not as rapidly as high degrees of heat, nor does it accomplish as rapid Viagra Buy In Canada destrtiction of tissue as does a Viagra Buy In Canada knife or a strong chemical such as fuming nitric acid. This so called "snow" is made use of, as you know, in the freezing microtome, and it is very convenient to take a specimen, e. g. a bit of cervix, and rapidly Viagra Buy In Canada harden it by freezing and make what we call a "frozen section" which can be covered with acacia, mounted, and cut with the microtome so that a diagnosis can be given at once. The surgeon thus ascertains whether the part is to be removed in toto as for malignancy, or in part. A special niicrotome is ordinarily required for this work. Again, cold is a very important factor in mod- ern day medicine in preserving specimens, bacterins, toxincs, and antitoxines. especially in transporta- tion. The use of cold, locally, has been in vogue •Read before the Philailel,>Hi,T C, .\Icrlical .Society. .Ta FRESCOI.X: -COLD CAUTERY 829 fur a lung time tor anaesthetic purposes. Abscesses may be opened after freezing with ice or ethyl chloride. \'ery recently the carbon dioxide has been used instead of ethyl chloride; it hardens the part but IS said to exert a rather beneficial influence in the after treatment. 1 wish to dwell in this paper, however, more par- ticularly Viagra Buy In Canada upon the use of carbon dioxide in the treat- ment of moles, naivi, warts, senile keratosis, lupus erythematosus, and skin epithelioma. This sub- stance was first used in dermatology by Pusey, of Chicago, and he wrote upon the subject in The American Medical Journal. It is a substance sim- ilar to liquid air. }ilorrow Viagra Buy In Canada also used it at the Lon-