there. Another was a carcinoma of the neck, with a recurrent mass just below the jaw secondary to carcinoma of the larynx, and shortly after deep therapy had been applied to the neck, the scar was a mass of secondary nodules along its length. In the third case the speaker excised part of the stomach for gastric carcinoma. Deep therapy was applied prophylactically, because he felt that his operation must have been an incomplete one. Within two months of the treatment having been commenced. masses could be felt deep down in the abdomen. In one case of retroperitoneal carcinoma, the primary growth probably being in the pancreas, for a mass could be felt there, enlarged glands existed in the right iliac fossa. That was in September, 1922. He thought the patient's life would be about three months. Dr. Douglas Webster applied deep therapy, after which the glands in the right iliac fossa disappeared, the patient seemed much better, and began to get about again. But the mass above began to grow again, and death took place two months ago. In that case he believed the deep therapy prolonged life about a year. For a man with carcinoma of the prostate, Mr. Handley buried radium into the lateral aspect of the prostate through punctures in the perineum. Improvement followed this, but he still had a mass in the right vesico-sacral fold, palpable per rectum, and he developed some glands in the right iliac fossa. After this one radium application, Dr. Webster treated the patient by deep X-ray therapy, having begun it in February, 1922. If the case had been left the patient would probably have been dead by now, but he was still living on, all the glands in the left iliac fossa had disappeared, and the former cedema of the left leg had now gone. An opinion as to the efficacy of the treatment was only possible after a long period of observation of cases. The technique was still fluid. His general view was that a medium must be observed between an X-ray dosage which was inadequate to act on the growth and that which was harmful to the patient, and he did not think that that balance had yet been effeetively struck. The use of buried radium, in suitable cases where the area to be dealt with was small, possessed great advantages over deep X-ray therapy, in that, with the radium, application of a maximum amount of irradiation of the growth could co-exist with a minimal irradiation of the tissues generally. In deep X-ray therapy, however, irradiation of the tissues generally was hard to avoid, and was usually deleterious in its effects.
