I have not myself had much experience recently in the use of iodine in this deformity, and what I had in former years was not favorable; but the results of Dr. Brainard, Dr. Morton of Glasgow, and others, have placed the operation on a new basis. The latter surgeon, in 1876, reported fourteen cases, eleven of which were successful; and in the majority not only was the sac obliterated, but improvement as to paralysis and general health occurred. The cases were not simply those in which connection with the spinal canal was naturally obliterated, and which might fairly be expected to recover, but included some of much more serious nature. The solution used ("Morton's solution") was- "iodine, 10 gr., iodide of potassium, 30 gr., glycerin, 1 oz.," and of this 1/2 to 1 dr. was injected after removal of more or less fluid, according to the case (Lancet, ii., 1876).

Dr. G. W. Thompson records an instructive illustration, in which the tumor over the sacral region was twelve inches in circumference ten days after birth; it was attached by a peduncle and communicated with the spinal canal. After tapping and removing about 2 oz. of fluid, 25 min. of Morton's solution were injected and the aperture sealed. There was much shock, and brandy was given freely. Gradual improvement, however, took place, and six months afterward only a mass of thickened skin remained (British Medical Journal, ii., 1878).

My colleague, Mr. Pearce Gould, has recorded an interesting case of recovery under similar treatment. The child, aged eighteen months, had a sessile tumor as large as a cricket-ball, situated over the last lumbar and sacral vertebrae, and communicating with the spinal canal. At the first operation 6 dr. of fluid were drawn off, and 1/2 dr. of Morton's solution injected; at the second operation 1 oz. was removed and 1 dr. injected; at a third, 2 1/2 oz. removed and 2 dr. injected. There was neither shock nor convulsion; improvement set in on the ninth day after the last operation, and ultimately only a flat mass of dense tissue remained; there was no paralysis ("Clinical Society's Transactions," vol. xi.).

Of two other cases treated by Mr. Gould after Morton's method, one died of purulent spinal meningitis a few days after the second injection; the other left the hospital and was not seen again.