e after the use of radium and becomes operable, it
should be removed before time is given it to resume its growth. It will
depend upon the subsequent course of the disease, whether or not a
second, or it may be even a third, application of radium will be
required.

Where neither radium nor X-rays is available or applicable, recourse may
be had to the injection of Coley's fluid, a preparation containing the
mixed toxins of the streptococcus of erysipelas and the bacillus
prodigiosus; or of selenium.

EPITHELIAL TUMOURS

An excessive and erratic growth of epithelium is the essential and
distinguishing feature of these tumours. The innocent forms are the
papilloma and the adenoma; the malignant, the carcinoma or cancer.

#Papilloma.#--A papilloma is a tumour which projects from a cutaneous or
mucous surface, and consists of a central axis of vascular fibrous
tissue with a covering of epithelium resembling that of the surface from
which the tumour grows. In the papillomas of the skin--commonly known as
_warts_--the covering consists of epidermis; in those growing from
mucous surfaces it consists of the epithelium covering the mucous
membrane. When the surface epithelium projects as filiform processes,
the tumour is called a _villous papilloma_, the best-known example of
which is met with in the urinary bladder. Papillomatous growths are
also met with in the larynx, in the ducts of the breast, and in the
interior of certain cystic tumours of the breast and of the ovary.
Although papillomas are primarily innocent, they may become the
starting-point of cancer, especially in persons past middle life and if
the papilloma has been subjected to irritation and has ulcerated. The
clinical features and treatment of the various forms of papilloma are
considered with the individual tissues and organs.

#Adenoma.#--An adenoma is a tumour constructed on the type of, and
growing in connection with, a secreting gland. In the substance of such
glands as the mamma, parotid, thyreoid, and prostate, adenomas are met
with as encapsulated tumours. When they originate from the glands of the
skin or of a mucous membrane, they tend to project from the surface, and
form pedunculated tumours or polypi.

Adenomas may be single or multiple, and they vary greatly in size. The
tumour is seldom composed entirely of gland tissue; it usually contains
a considerable proportion of fibrous tissue, and is then called a
_fibro-adenoma_. When it contains