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cover the special indications of a given case, and they may be entirely contraindicated a week fron
the time that they have been prescribed. I hope · I have made it clear that amateur prescribing
and self-dosing is foolish and risky and that ordering of drugs, especially of powerful drugs, should invariably be left to the physician who is able to bear the responsibility.'
MOLES: A METHOD OF TREATMENT.
By C. S. NEISWANGER, M, D., Chicago, Illinois.
sto taking of moles
IN speaking of moles I do not refer worse and yet never have the cancer, because they
to a mass formed in the uterus had not this inherent tendency.
the body, generally on the part the knife or acids, and the patient has the inwhere it is least wanted—the face.
herent tendency, but it is also true that the presThere are several things about moles that doence of the mole, especially about the face, is a not seem to be well understood by the medical constant source of danger. A cancer is caused profession, consequently the laity suffer from lack by constant or repeated irritation of degenerate of advice, or poor advice on the subject.
cells, and the mole being in such location as to be A press dispatch from Paris recently appeared repeatedly injured, the result is evident; in fact, I in the daily papers, stating that the Academy of believe I never treated an epithelioma about the Medicine advised against the removal of these face that did not come from a degenerated mole. growths, as such operation "might produce a can- Our own Dr. Nicholas Senn was a great sticcer.” It is just such statements as this that are kler for the removal of these blemishes as early misleading because they do not tell the whole in life as possible because in early life, up to the truth, and are liable to do much barm.
age of 40, the tissues have more resistance and The tendency to have a malignant growth-a no trouble will ensue from the removal of the cancer—is not an acquired tendency, but an innate growth, while if left alone it is almost sure ultitendency, acquired by inheritance. It is not at mately to cause serious trouble. all necessary that your patient give a history of A great deal depends upon how the growth is cancer in the immediate family to establish this removed. The knife, acids and cautery produce malignant tendency, as any strumous or tubercu- much irritation and invariably leave a scar. From lous conditions are sometimes amply sufficient. an experience covering many years, I believe that
A lady came to consult me recently about a negative galvanism gives the best results and is well-developed carcinoma of the breast. She devoid of the dangers of other procedures. The laughed when I commenced asking her about her growth turns black and comes off in a few days antecedents, and remarked: "I have had all those as a crust, leaving only a red spot that entirely questions asked me before. You are trying to disappears in a few weeks. There is practically ascertain whether there has been any cancers in no limit to the size of a benign growth that may our family. There never has been." I said to be removed by this method, but it is my practice her, "Is your mother living?” She replied, “No, invariably to remove the growth at a single mother died when I was a child.” “Of what did sitting. If the mole is hairy, remove the hairs by she die?" I asked. “Consumption," was the reply. negative galvanism first, as the removal of the “This growth on my breast came from striking it hairs will destroy the greater part of the growth, against the corner of the bureau.”
while the removal of the growth will not destroy Here was a patient who had an inborn tendency the hairs. to have a malignancy, and all that was necessary The question now arises: If these growths are was an exciting cause to bring it about. She might allowed to remain until middle life or even old have lived to be an old woman but for the injury age when the tissues have almost entirely lost their caused by striking the bureau.
resistance, will their removal cause sufficient irriSome persons fall, and the result is a cancer. tation to produce a cancer in persons who have Other persons may fall and hurt themselves much the inherent tendency? In an experience of over
twenty-five years of removing moles by the proc- There may be many patients who have cancers ess I have mentioned I have had only two cases whose family history is negative as to the tenin which an epithelioma resulted, and in both of dency to have cancer, but one thing I have nothese cases the growth was not entirely removed ticed that is not of record. A growth of moles at a single sitting, as I have advised, but was indicates a tendency to malignancy. In fact, I kept in a constant state of irritation by repeated have rarely treated a patient for a malignant operations. Both of these cases, however, were growth that did not have a number of moles. eventually cured with the X-Ray. On the other While the existence of moles in relation to a hand, I have treated a number of epitheliomas that malignant growth might be purely coincidental, it were caused by the removal of moles with the is hardly probable that they could be so uniknife or caustics.
versally associated without good grounds for the I believe the physician should tell his patients assertion I have made. of their tendency to have a malignancy so that I am, therefore, firmly of the belief that these avoidable accidents may be guarded against. It blemishes should be removed as early in life and is well also to advise the removal of moles or other with as little irritation as possible, for the same benign growths that may be about the mouth, reason that "an empty house is better than a bad nose, eyes or breast.
THE ROOM BEYOND.*
AROTHERS had been sitting with When he was asked to go upstairs he followed
his head on his hand. It was a mechanically. It was not the first time he had habit that was growing on him. been there. He remembered that corridor to In the last few weeks he was the right, where he had taken the deposition of more and more frequently to a dying murderer. The man had killed his wife
be found in that position, pull- for loving another man. and then had put a ing himself together with a jerk at the banging
bullet through his own lungs. Carothers wonof a door or the entrance of his clerk. He had
dered dully if it were not rather the better way. grown thinner, and there were whispers of night
It was over quickly, for one thing. One didn't ly dissipations that left their mark the next
keep on and on, with a dull ache that, morning in congested eyes and nervous hands. But the men who knew Carothers knew better.
“Will you wait here?”' the attendant asked, The clock in the square chimed two, and he
he opening the door into another small, bare room,
opening the came to himself with a start. His watch. lving a replica of the one downstairs. "The doctor on the desk in front of him. was open at the has telephoned that he will be here soon.” back. Carothers looked guiltily at the door and
Carothers did not sit down. A nurse in a snapped the watch shut. Then he took his hat white gown was writing at a desk, now and then and went out.
consulting a brown note-book. She was as imWhen he reached the hospital the doctor had passive as everything else, Carothers thought. not arrived. Carothers remembered the prover- It was a warm day, and the window was bial tardiness of the profession and cursed his closed. Carothers raised it an inch or two, then own punctuality. Everywhere around him were he turned to the nurse. the hush, the bare cleanliness, the dreary gray, “Does it make any difference if I open the of the hospital corridors. There was something window?" he asked. “Germs-or anything of in the swept and ungarnished emptiness of the that kind 99, place that reminded him, as he waited in the
The nurse looked up. little reception-room, of the bleakness of the
“Not at all,” she said briskly. “Open it if last two months. The place was cool, too, after
you wish.” the glare of the street, and Carothers shivered. S
“I was to meet Dr. Hilliard.” The silence * Copyright, The Frank A. Munsey Co. had been oppressing Carothers, and he was glad
of any excuse to talk. “It must be time for He was talking to her as he shook hands with him."
Carothers and glanced over the brown note-book. The nurse consulted the watch in the broad “Has Dr. Stevenson arrived ?” he asked band of her apron.
briskly. “He will be here very soon,” she said, and “About ten minutes ago, doctor.” went on with her writing.
“Tell them to start, please, Miss Lyons. I'll Carothers paced the room, his hands in his be there in a few minutes.'' pockets. Finally he stopped near the desk.
II "I don't know how you women stand it here,” As the nurse went out, Hilliard looked sharply he said. “I haven't been here fifteen minutes, at Carothers. ·and I feel as if the walls were closing in on “Pretty well used up, aren't you, Billy? Heat, me. It seems like a huge piece of machinery, and all that?”. with about as much feeling. They feed people “Especially “all that,'" Carothers said. “But into the wheels and cogs, and grind off an arm I'm not sick. If you brought me here to talk or an appendix-I suppose I'm nervous. It's about my condition—" hot today, and this smell of drugs knocks me "I didn't,” the doctor interposed. "To tell
you the truth, I'm not much interested in your The nurse smiled a little, but she looked keenly condition." at Carothers' haggard, handsome face.
Carothers did not resent the tone or the im“We are not all pieces of the machinery,” plication. she said gently. “You'd better sit down, and “You brought me here for something," he I'll bring some icewater."
said wearily. “What is it? Some poor devil's When she came back, with a rustling of will, or what?" starched skirts, Carothers was still standing by The doctor had been looking over the charts the desk, looking at the records on it.
with practised eyes. Now he put them down “This is what I mean," he said. “Here you with almost unnecessary deliberation. say, 'Twenty-one slept badly; was very nervous, "Billy,” he said gravely, “how long is it asking constantly for the baby; has not yet been since you forced Alice to leave you?'' told the baby is dead.' Let me see—not two Carothers stopped his nervous pacing; he was dozen words, and I suppose you're used to it, very white, and his nostrils dilated nervously. but there's the tragedy of a life right there.” “Why?” he asked, after a minute. • The nurse bunched her papers and locked "It's over a month, isn't it?” them in a drawer.
“Two months,” Carothers said sullenly. “Two "It is a sad case," she said, "but visitors months of hell!" are not supposed to see those records.".
"I'm glad of that." The doctor was polishCarothers resumed his pacing of the room. It ing his glasses and holding them to the light seemed to be a sort of anteroom. Now and then critically. “I'm glad it has been a bad time." a nurse bustled through, or a smooth-faced young Then his indignation suddenly mastered him. doctor. From the other side of the door came “My God, boy, if it has been that to you, what the muffled sound of conversation, and now and has it been to Alice? If you lived a thousand then a metallic jingle that set his frayed nerves years, do you think you could ever atone to your on edge. The nurse was marking zigzag lines wife for one week of that time?'' on a black-and-white chart.
"We needn't go over it,” Carothers said dully. “It couldn't do any harm to tell me a little “If you wish to tell me what you think of me, about twenty-one,” he said finally, pausing be- why not some other place than this?'' side the desk. “It-it haunts me, for some rea- The doctor was plainly struggling to be cool. son or other."
“If it had been only your wife," he said, The nurse looked faintly annoyed at his per- “the injustice would not have been so terrible; sistence.
but if you couldn't think of Alice, why couldn't “It isn't really as bad as you think,” she said. you think of little Marjorie ?" "It was a young baby, and she still has her Carothers turned on him fiercely. "Think of husband.”
her!” he snarled. “Do I ever think of anything "I think you overrate the value of a husband else? Don't I sit like a blatant ass in the office as an asset.” Carothers could not keep the bit- staring at this and letting my business go to terness out of his voice. “It is only the woman the devil?' He had taken his watch out, and
1 nanal!! who—ah, doctor, punctual as usual!”
with unsteady fingers was opening the back of The nurse got up as Dr. Hilliard came in the case. He looked lingeringly at the miniature inside—the miniature of a baby girl, with use? Stevenson-it was always Stevenson, even wide, candid brown eyes. Then he held out the after we were married. He came almost every watch to the other man. “You have seen her day. When Marjorie was old enough, it was lately, doctor," he said hoarsely. “Is—is she his toys she played with; it was his candy she much changed? They grow so fast at that age, sickened on. It was Uncle Stevie this, Uncle you know."
Stevie that. I fell over Uncle Stevie's dolls on He was watching the doctor with wistful eyes. the stairs. Alice read his books and brightened Hilliard looked critically at the picture.
her rooms with his flowers. It was always Stev“Yes, she's like that,” he said. “She's like enson!” her mother."
“Did it ever occur to you that he came proCarothers groaned under his breath and went fessionally?”. to the window. All the beaten-down, fought-out “Bah! I got no bills for professional vists!” emotion of the last two months was coming back, “That was a mistake, certainly," the doctor smothering and choking him. If he could only said dryly. have shrieked or stormed! But here, in this An orderly in a pink-striped coat came hurquiet place—
riedly from the room beyond and said something “You never understood, doctor," he said at in a low tone. The doctor questioned him anxlast, still looking with unseeing eyes through the iously. window. “If you had had to go home, night “I'll go in,” he said, and the man hurried after night, to that quiet house—why, the very away. sight of the empty nursery at the head of the “And then,” Carothers went on, as the door stairs, with the toys all standing around in stiff closed softly, she went to the theater one afterrows!” He stopped and choked. “I've been
noon. I thought she was depressed, and it might stopping at the club lately."
cheer her. Poor fool that I was! I stopped at The nurse came in and said something in a a corner to get some violets." He laughed a low tone. (arothers was not listening; he was little, an ugly, ominous laugh. "Violets! And back in the empty house, with the rows of toys she went past, in a cab, with her head on Stevand the stillness. As the nurse went out, Caro- enson's shoulder!!! thers turned slowly.
There were sounds from the other room now “What's Stevenson doing here?” he said sus
-a scraping of chairs and slightly raised voices. piciously. “This isn't any plan of yours, is The doctor watched the door. When no one it, to—"
came, however, he turned to Carothers. The doctor held up a warning hand.
“You're a queer family," he said, “you Caro“Any interest I may take in your affairs is therses. You are money-getters, all of you. Your not on your account,” he said. “When I see only intelligence is •your financial intelligence. a young and innocent woman turned out of her You are all the same. Your mother died before home, or practically so'-as Carothers made a your father would believe she was ill. Your ingesture of dissent-“by a man who has sworn tentions are good, I think, but you lack the finer to care for her—thrust out to the tender mercies instincts." of people who are always glad to see a beautiful Carothers picked up his hat. woman in the dust, in the mud-by the Lord, “Dr. Hilliard, I don't intend to allow you Billy Carothers, I can't help hoping that there's to quarrel with me,” he said. “If you have something coming to you some day in the way finished this interesting dissection of myself and of punishment!''
my family history, I will go." Carothers had flushed. Now he came and stood "Don't! I have not finished." The doctor before the doctor, his chin low, his eyes a somber ran his fingers nervously through his thick gray fire.
hair. "Billy, you have never been ill, that I “What did you bring me here for? To tell can remember.” Carothers looked at him silentme that my wife is—all that she should be? I ly. "You have never been ill, and you have a. tell you, I know better. Stevenson always loved morbid shrinking from illness in others. You her; he was crazy about her, poor fool! If he needn't deny it; I know. It's a family charachad married her, who knows? Perhaps he'd be teristic. Did it never occur to you, that night where I am now!”
when you refused to allow Alice to explain“That will do!” The doctor was losing con- did it never occur to you to imagine—the truth?' trol of his temper.
"The truth?" "They thought he'd shoot himself when Alice "The truth. Billy, if your stupidity was not married me. Not he, the-oh, well, what's the an excuse, I think I'd shoot you. Do you think
you can believe me when I tell you that for what kind of a fool, what kind of a beast, had years Alice has been a sick woman? That there he been? have been times when she could scarcely move, After a while some one touched him on the and yet she got up and dressed to be bright for shoulder. It was a strange nurse, with a hypoyou when you came home, tired? She knew you, dermic-tray in her arms. yon see.”
“Let me pass," she said. “Hurry, please;"> “Good Lord!”
but still Carothers barred the door. “I couldn't help her, and I turned her over “How is she?” he gasped, his throat dry and to Stevenson. It's too late to be sorry for that. rasping. He did his best for her; your persistent blind “I don't know," the nurse said evasively. ness was the greatest handicap. That afternoon “Let me pass, please." when you saw her with him in a cab she had “Not until you answer my question. Has she fainted at the theater."
-has she a chance? She isn't dying, is she? Carothers' hat had dropped from his hand You can tell me that much, anyhow!" and lay unnoticed on the floor. His world seemed He had caught her by the shoulder, and she to have slipped from under his feet suddenly, wrenched herself free angrily. without warning. There was nothing left but a “If you don't stand aside— " she began, but suffering woman, and the injustice of those last Carothers was beyond reason. bitter months.
“You can tell me something," he said, his “Where is she?" He had groped for the face livid. “Can't you see I'm going crazy? back of a chair and was holding to it. “If she Oh, you're not a woman; you're a machine!” is-is ill—" Then the old doubts came back. “Every instant you keep me, you are lessen“You are absolutely sure?” he asked. “She ing her chances,” the nurse said coldly. might tell you that, and—”.
Carothers reeled aside, and the door shut in “Will you never understand ?” the doctor said his face. From the room beyond there came a impatiently. “Isn't there a grain of humanity confusion of muffled voices, of hurried steps on in you? I tell you—".
a tiled floor. Now and then, too, there was a · The door into the room beyond opened sud- metallic jingling--Carothers knew what it meant, denly, and Miss Lyons came in. She was star- and with his head on the little mahogany desk tled out of her impassiveness, and her face was he sobbed tearlessly. rather white.
After a wait that seemed ages long, a doctor “Dr. Stevenson wants you at once,” she said came out and hurried to the telephone beside nervously. “The patient is sinking under the the desk. anesthetic.''
“Where's that oxygen?” he called excitedly. The doctor was at the door in an instant. "This is the worst pharmacy I ever saw! I sent Then, with his hand on the knob, he turned.
for oxygen five minutes ago. Yes, for Heaven's “I brought you here,” he said, “because I sake. hurry!" thought you might be needed. Stevenson is
Carothers gripped his arm as he turned. operating--making his last stand to save Alice's “How is she?" he said, struggling for comlife. If you have a prayer to say, say it now!”. posure. “She isn't-she isn't dead, is she?” III.
The doctor looked away. He was young, and As the door snapped shut behind Hilliard, things were bad in that next room. Carothers stood gazing at it with stupefied eyes. "Try to think of something else,” he said. She was in there, then! She was failing, even “There has been a sinking spell, but she's living, now her life might be going, going, and he had and we never give up while there's life.” shut himself out! He was on the other side of The relentless door closed behind him. Carothe door!
thers could have beaten at it with his hands. All the awful possibilities of that room beyond Perhaps there was something that could be done, came to him, overwhelmed him, buried him. She and they would forget to do it. Or the knife was there, beyond his reach; he had always failed might slip-those things happened sometimes; her, and now he was failing her again. He stag- but not with Stevenson, and Stevenson loved her. gered to the door and fell against it, hiding his It was only another draft from the cup of deface in his shaking arms. Out of the blackness spair to know how much better, more unselfishly, came the little homely things he had tried to Stevenson had loved her. forget—her little gaities, the way she slept with The door into the hallway opened, but Caroher hand under her cheek. He remembered the thers did not look up. night she taught Marjorie her baby-prayer. God, “Now just wait here and sit still," a woman's