The following case, which occurred in my practice some years ago, will illustrate some of the risks and the possibilities of treating large cysts by strong iodine injections. A gentleman, aged seventy, had an enlargement of the abdomen, which was obscure in its nature, and variously diagnosed as dependent on liquid effusion or a solid growth from the under surface of the liver. Attacked one day with rigors and sudden, violent pain, he became jaundiced and collapsed, and when seen by me was semicomatose and apparently dying. Some obscure fluctuation being detected in the enlargement, a trocar was inserted, and 21 to 23 pints of thick, grumous fluid, with some pus, were drawn off; this was examined by special microscopists without detection of any hydatids or hooklets. Three weeks afterward, 16 pints of fluid were drawn off, and 16 oz. of pure tincture of iodine (British Pharmacopoeia) injected, allowed to remain for twenty minutes in the sac, and then some of it to escape.

Severe effects soon followed the injection: salivation, soreness of mouth and throat, sickness, eructations, headache, giddiness, tinnitus au-rium, muscae volitantes, etc., accompanied by palpitation and pyrexia; the pulse was 140, weak and irregular, the temperature 101.8° F. Epis-taxis occurred twice during the first thirty-six hours; tightness across the chest and pain at the epigastrium were complained of, and frequent thin, watery stools were passed; the general condition was one of extreme nervousness, prostration, and unrest.

On the second and third days the temperature, which was highest in the afternoon, varied from 101° to 104° F., and the pulse from 110 to 140. Pains in the limbs and in the loins set in, and were felt also in the long bones, which presented all the evidence of periostitis; synovial effusion distended the left knee-joint; the urine, which was at first pale and profuse, became scanty and bloody, and both it and the saliva contained large quantities of iodine; the salivary glands were painful and swollen, and the palate and fauces sore and inflamed; there was constant short, dry cough, with more or less aphonia.

All these symptoms continued to increase until the end of the fourth day, when an eruption, somewhat like measles, appeared, with apparent relief to many of the urgent symptoms. By the fifth day the periostitis had considerably subsided, and by the ninth, most of the other symptoms had disappeared. Iodine was, however, excreted by the urine for about sixteen days, and albumen for twenty-five days; during the whole time nourishment was taken well. After the severe attack convalescence progressed favorably, and the patient lived for two years afterward, and died from the effects of cholesterin calculus.