risk if properly
used. The healthy parts should be protected by lead-foil. Exposure
should be two to five times weekly, at a distance of three to eight
inches, and from five to twenty minutes, employing a tube of medium
vacuum. Unfortunately the method is usually slow. The radium treatment
is essentially similar to that by the _x_-ray.

The much better plan, as already intimated, is to employ one of the
several operative or caustic methods, and supplementing, while healing,
with the _x_-ray.

#Paget's Disease of the Nipple.#
(_Synonyms:_ Malignant Papillary Dermatitis; Paget's Disease.)

#What do you understand by Paget's disease of the nipple?#

Paget's disease is a rare, inflammatory-looking, malignant disease of
the nipple and areola in women, usually of advancing years, eventually
terminating in cancerous involvement of the entire gland.

#Describe the symptoms of Paget's disease.#

The first symptoms, which usually last for months or years, are
apparently eczematous, accompanied with more or less burning, itching
and tingling. Gradually, the diseased area, which is sharply-defined,
and feels like a thin layer of indurated tissue, presents a florid,
intensely red, very finely-granular, raw surface, attended with a more
or less copious viscid exudation. Sooner or later retraction and
destruction of the nipple, followed by gradual scirrhous involvement of
the whole breast, takes place.

#What is the pathology of Paget's disease?#

Although it was thought at one time to be a cancerous disease resulting
from a continued eczematous inflammation of the parts, there is now but
little doubt that it is of malignant nature from the earliest stages.
The psorosperm-like bodies found, to the presence of which the disease
has by some authorities been attributed (psorospermosis), are now known
to be merely changed and degenerated epithelia. The morbid changes
consist of an inflammation of the papillary region of the derma, leading
to [oe]dema and vacuolation of the constituent cells of the epidermis,
followed by their complete destruction in places and their abnormal
proliferation in others (Fordyce).

#State the diagnostic features of Paget's disease.#

The age of the patient; the sharp limitation; the well-defined,
indurated film of infiltration; the peculiar, red, raw, granulating
appearance; and, later, the retraction of the nipple; and, finally, the
involvement of the deeper part