cover the special indications of a given case, and they may be entirely contraindicated a week from 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..

I I

N speaking of moles I do not refer to a mass formed in the uterus by an ovum, nor a hydatid mole, but just a plain brown growth that appears on different parts of the body, generally on the part where it is least wanted-the face.

There are several things about moles that do not seem to be well understood by the medical profession, consequently the laity suffer from lack of advice, or poor advice on the subject.

A press dispatch from Paris recently appeared in the daily papers, stating that the Academy of Medicine advised against the removal of these growths, as such operation "might produce a cancer." It is just such statements as this that are misleading because they do not tell the whole truth, and are liable to do much harm.

The tendency to have a malignant growth-a cancer is not an acquired tendency, but an innate tendency, acquired by inheritance. It is not at all necessary that your patient give a history of cancer in the immediate family to establish this malignant tendency, as any strumous or tuberculous conditions are sometimes amply sufficient.

A lady came to consult me recently about a well-developed carcinoma of the breast. She laughed when I commenced asking her about her antecedents, and remarked: "I have had all those questions asked me before. You are trying to ascertain whether there has been any cancers in our family. There never has been." I said to her, "Is your mother living?" She replied, "No, mother died when I was a child." "Of what did she die?" I asked. "Consumption," was the reply. "This growth on my breast came from striking it against the corner of the bureau."

Here was a patient who had an inborn tendency to have a malignancy, and all that was necessary was an exciting cause to bring it about. She might have lived to be an old woman but for the injury caused by striking the bureau.

Some persons fall, and the result is a cancer. Other persons may fall and hurt themselves much

worse and yet never have the cancer, because they had not this inherent tendency.

Now, it is true that the removal of a mole might be sufficient cause for the production of a cancer, more especially if the mole be removed by the knife or acids, and the patient has the inherent tendency, but it is also true that the presence of the mole, especially about the face, is a constant source of danger. A cancer is caused by constant or repeated irritation of degenerate cells, and the mole being in such location as to be repeatedly injured, the result is evident; in fact, I believe I never treated an epithelioma about the face that did not come from a degenerated mole.

Our own Dr. Nicholas Senn was a great stickler for the removal of these blemishes as early in life as possible because in early life, up to the age of 40, the tissues have more resistance and no trouble will ensue from the removal of the growth, while if left alone it is almost sure ultimately to cause serious trouble.

A great deal depends upon how the growth is removed. The knife, acids and cautery produce much irritation and invariably leave a scar. From an experience covering many years, I believe that negative galvanism gives the best results and is devoid of the dangers of other procedures. The growth turns black and comes off in a few days as a crust, leaving only a red spot that entirely disappears in a few weeks. There is practically no limit to the size of a benign growth that may be removed by this method, but it is my practice invariably to remove the growth at a single sitting. If the mole is hairy, remove the hairs by negative galvanism first, as the removal of the hairs will destroy the greater part of the growth, while the removal of the growth will not destroy the hairs.

The question now arises: If these growths are allowed to remain until middle life or even old age when the tissues have almost entirely lost their resistance, will their removal cause sufficient irritation to produce a cancer in persons who have the inherent tendency? In an experience of over

twenty-five years of removing moles by the process I have mentioned I have had only two cases in which an epithelioma resulted, and in both of these cases the growth was not entirely removed at a single sitting, as I have advised, but was kept in a constant state of irritation by repeated operations. Both of these cases, however, were eventually cured with the X-Ray. On the other hand, I have treated a number of epitheliomas that were caused by the removal of moles with the knife or caustics.

I believe the physician should tell his patients of their tendency to have a malignancy so that avoidable accidents may be guarded against. It is well also to advise the removal of moles or other benign growths that may be about the mouth, nose, eyes or breast.

There may be many patients who have cancers whose family history is negative as to the tendency to have cancer, but one thing I have noticed that is not of record. A growth of moles indicates a tendency to malignancy. In fact, I have rarely treated a patient for a malignant growth that did not have a number of moles. While the existence of moles in relation to a malignant growth might be purely coincidental, it is hardly probable that they could be so universally associated without good grounds for the assertion I have made.

I am, therefore, firmly of the belief that these blemishes should be removed as early in life and with as little irritation as possible, for the same reason that "an empty house is better than a bad tenant."

C

AROTHERS had been sitting with his head on his hand. It was a habit that was growing on him. In the last few weeks he was more and more frequently to be found in that position, pulling himself together with a jerk at the banging

of a door or the entrance of his clerk. He had

grown thinner, and there were whispers of nightly dissipations that left their mark the next morning in congested eyes and nervous hands. But the men who knew Carothers knew better.

The clock in the square chimed two, and he came to himself with a start. His watch, lying on the desk in front of him, was open at the back. Carothers looked guiltily at the door and snapped the watch shut. Then he took his hat and went out.

When he reached the hospital the doctor had not arrived. Carothers remembered the proverbial tardiness of the profession and cursed his own punctuality. Everywhere around him were the hush, the bare cleanliness, the dreary gray, of the hospital corridors. There was something in the swept and ungarnished emptiness of the place that reminded him, as he waited in the little reception-room, of the bleakness of the last two months. The place was cool, too, after the glare of the street, and Carothers shivered. Copyright, The Frank A. Munsey Co.

When he was asked to go upstairs he followed mechanically. It was not the first time he had been there. He remembered that corridor to the right, where he had taken the deposition of a dying murderer. The man had killed his wife for loving another man, and then had put a bullet through his own lungs. Carothers wondered dully if it were not rather the better way. It was over quickly, for one thing. One didn't keep on and on, with a dull ache that

"Will you wait here?" the attendant asked, opening the door into another small, bare room, a replica of the one downstairs. "The doctor has telephoned that he will be here soon."

Carothers did not sit down. A nurse in a white gown was writing at a desk, now and then consulting a brown note-book. She was as impassive as everything else, Carothers thought.

It was a warm day, and the window was closed. Carothers raised it an inch or two, then he turned to the nurse.

"Does it make any difference if I open the window?" he asked. "Germs-or anything of that kind?''

The nurse looked up.

"Not at all," she said briskly. "Open it if you wish."

"I was to meet Dr. Hilliard." The silence had been oppressing Carothers, and he was glad

ture inside the miniature of a baby girl, with wide, candid brown eyes. Then he held out the watch to the other man. "You have seen her lately, doctor," he said hoarsely. "Is-is she much changed? They grow so fast at that age, you know."

He was watching the doctor with wistful eyes. Hilliard looked critically at the picture.

"Yes, she's like that," he said. "She's like her mother."

Carothers groaned under his breath and went to the window. All the beaten-down, fought-out emotion of the last two months was coming back, smothering and choking him. If he could only have shrieked or stormed! But here, in this quiet place

"You never understood, doctor," he said at last, still looking with unseeing eyes through the window. "If you had had to go home, night after night, to that quiet house-why, the very sight of the empty nursery at the head of the stairs, with the toys all standing around in stiff rows!" He stopped and choked. "I've been stopping at the club lately."

The nurse came in and said something in a low tone. Carothers was not listening; he was back in the empty house, with the rows of toys and the stillness. As the nurse went out, Carothers turned slowly.

"What's Stevenson doing here?" he said suspiciously. This isn't any plan of yours, is it, to-"

The doctor held up a warning hand.

"Any interest I may take in your affairs is not on your account," he said. "When I see a young and innocent woman turned out of her home, or practically so'-as Carothers made a gesture of dissent-"by a man who has sworn to care for her-thrust out to the tender mercies of people who are always glad to see a beautiful woman in the dust, in the mud-by the Lord. Billy Carothers, I can't help hoping that there's something coming to you some day in the way of punishment!"

Carothers had flushed. Now he came and stood before the doctor, his chin low, his eyes a somber fire.

"What did you bring me here for? To tell me that my wife is all that she should be? I tell you, I know better. Stevenson always loved her; he was crazy about her, poor fool! If he had married her, who knows? Perhaps he'd be where I am now!"

"That will do!" The doctor was losing control of his temper.

"They thought he'd shoot himself when Alice married me. Not he, the oh, well, what's the

use? Stevenson-it was always Stevenson, even after we were married. He came almost every day. When Marjorie was old enough, it was his toys she played with; it was his candy she sickened on. It was Uncle Stevie this, Uncle Stevie that. I fell over Uncle Stevie's dolls on the stairs. Alice read his books and brightened her rooms with his flowers. It was always Stevenson!"

"Did it ever occur to you that he came professionally?"

"Bah! I got no bills for professional vists!'' "That was a mistake, certainly," the doctor said dryly.

An orderly in a pink-striped coat came hurriedly from the room beyond and said something in a low tone. The doctor questioned him anxiously.

"I'll go in," he said, and the man hurried

away.

"And then," Carothers went on, as the door closed softly, "she went to the theater one afternoon. I thought she was depressed, and it might cheer her. Poor fool that I was! I stopped at a corner to get some violets." He laughed a little, an ugly, ominous laugh. "Violets! And she went past, in a cab, with her head on Stevenson's shoulder!''

There were sounds from the other room now -a scraping of chairs and slightly raised voices. The doctor watched the door. When no one came, however, he turned to Carothers.

"You're a queer family," he said, "you Carotherses. You are money-getters, all of you. Your only intelligence is your financial intelligence. You are all the same. Your mother died before your father would believe she was ill. Your intentions are good, I think, but you lack the finer instincts."

Carothers picked up his hat.

"Dr. Hilliard. I don't intend to allow you to quarrel with me," he said. "If you have finished this interesting dissection of myself and my family history, I will go."

"Don't! I have not finished." The doctor ran his fingers nervously through his thick gray hair. "Billy, you have never been ill, that I can remember." Carothers looked at him silently. "You have never been ill, and you have a morbid shrinking from illness in others. You needn't deny it; I know. It's a family characteristic. Did it never occur to you, that night when you refused to allow Alice to explaindid it never occur to you to imagine the truth?"" "The truth?"

"The truth. Billy, if your stupidity was not an excuse, I think I'd shoot you. Do you think

you can believe me when I tell you that for years Alice has been a sick woman? That there have been times when she could scarcely move, and yet she got up and dressed to be bright for you when you came home, tired? She knew you, you see.''

"Good Lord!".

"I couldn't help her, and I turned her over to Stevenson. It's too late to be sorry for that. He did his best for her; your persistent blindness was the greatest handicap. That afternoon when you saw her with him in a cab she had fainted at the theater."

Carothers' hat had dropped from his hand and lay unnoticed on the floor. His world seemed to have slipped from under his feet suddenly, without warning. There was nothing left but a suffering woman, and the injustice of those last bitter months.

"Where is she?" He had groped for the back of a chair and was holding to it. "If she is-is ill-" Then the old doubts came back. "You are absolutely sure?" he asked. "She might tell you that, and-"'

"Will you never understand?" the doctor said impatiently. "Isn't there a grain of humanity in you? I tell you-'

The door into the room beyond opened suddenly, and Miss Lyons came in. She was startled out of her impassiveness, and her face was rather white.

"Dr. Stevenson wants you at once," she said nervously. "The patient is sinking under the anesthetic."'

The doctor was at the door in an instant. Then, with his hand on the knob, he turned.

"I brought you here," he said, "because I thought you might be needed. Stevenson is operating making his last stand to save Alice's life. If you have a prayer to say, say it now!''

III.

As the door snapped shut behind Hilliard, Carothers stood gazing at it with stupefied eyes. She was in there, then! She was failing, even now her life might be going, going, and he had shut himself out! He was on the other side of the door!

All the awful possibilities of that room beyond came to him, overwhelmed him, buried him. She was there, beyond his reach; he had always failed her, and now he was failing her again. He staggered to the door and fell against it, hiding his face in his shaking arms. Out of the blackness came the little homely things he had tried to forget her little gaities, the way she slept with her hand under her cheek. He remembered the night she taught Marjorie her baby-prayer. God,

what kind of a fool, what kind of a beast, had he been?

After a while some one touched him on the shoulder. It was a strange nurse, with a hypodermic-tray in her arms.

"Let me pass," she said. "Hurry, please;" but still Carothers barred the door.

"How is she?" he gasped, his throat dry and rasping.

"I don't know," the nurse said evasively. "Let me pass, please."

"Not until you answer my question. Has she -has she a chance? She isn't dying, is she? You can tell me that much, anyhow!"

He had caught her by the shoulder, and she wrenched herself free angrily.

"If you don't stand aside-" she began, but Carothers was beyond reason.

"You can tell me something," he said, his face livid. "Can't you see I'm going crazy? Oh, you're not a woman; you're a machine!"

"Every instant you keep me, you are lessening her chances," the nurse said coldly.

Carothers reeled aside, and the door shut in his face. From the room beyond there came a confusion of muffled voices, of hurried steps on a tiled floor. Now and then, too, there was a metallic jingling-Carothers knew what it meant, and with his head on the little mahogany desk he sobbed tearlessly.

After a wait that seemed ages long, a doctor came out and hurried to the telephone beside the desk.

"Where's that oxygen?" he called excitedly. "This is the worst pharmacy I ever saw! I sent for oxygen five minutes ago. Yes, for Heaven's sake, hurry!"

Carothers gripped his arm as he turned.

"How is she?" he said, struggling for composure. "She isn't she isn't dead, is she?" The doctor looked away. He was young, and things were bad in that next room.

"Try to think of something else," he said. "There has been a sinking spell, but she's living, and we never give up while there's life."

The relentless door closed behind him. Carothers could have beaten at it with his hands. Perhaps there was something that could be done, and they would forget to do it. Or the knife might slip-those things happened sometimes; but not with Stevenson, and Stevenson loved her. It was only another draft from the cup of despair to know how much better, more unselfishly, Stevenson had loved her.

The door into the hallway opened, but Carothers did not look up.

"Now just wait here and sit still," a woman's