?#

The variety, extent, and rapidity of the process. The superficial form
may exist for years, and give rise to no alarm; whereas the
deeper-seated varieties are always to be viewed as serious, and are,
indeed, often fatal. Involving the genitalia, its course is often
strikingly rapid. Relapses, after removal, are not uncommon.

#What is the special object in view in the treatment of epithelioma?#

Thorough destruction or removal of the epitheliomatous tissue.

#How is the destruction or removal of the epitheliomatous tissue
effected?#

By the use of such caustics as caustic potash, chloride-of-zinc paste,
pyrogallic acid, arsenic, and the galvano-cautery; and by operative
measures, such as excision and erasion with the dermal curette, and by
the _x_-ray. (See treatment of lupus vulgaris.)

In small lesions the use of an arsenical paste is a most admirable
method of treatment, although somewhat painful. The paste is made of one
part powdered acacia and one to two parts arsenious acid; at the time of
application sufficient water is added to make a paste. This is applied
thickly, and a piece of lint superimposed. A good deal of pain and
inflammatory swelling ensue; at the end of twenty-four hours the part is
poulticed till the slough comes away; the ulcer is then treated as a
simple ulcer, under which healing takes place. Occasionally a second
application is found necessary.

Upon the whole, the best method in the average case is to curette
thoroughly, and supplement with momentary cauterization, with caustic
potash, or with several days' use of the pyrogallic acid ointment.
During the healing process, short exposures to the Roentgen ray--about
every three to five days--is good practice.

The degenerative changes in the beginning of scurfy, seborrh[oe]ic spots
or patches seen in old people can frequently be lessened or wholly
stopped by the daily application of an ointment containing 5 to 10 per
cent. of sulphur and 2 to 5 per cent. of salicylic acid.

#What can be said of the value of the x-ray in epithelioma?#

The _x_-ray method is now much in vogue, and proves curative in many
superficial cases, and of benefit in some of the deeper-seated
varieties. In most cases it must be pushed to the point of producing a
mild _x_-ray erythema; and in some instances benefit or cure only occurs
after more active exposure, sufficient to cause an _x_-ray burn of the
second degree. The method is not attended with much