[Reprinted from The Medical News, May 26, 1894.], 
SULPHURIC-ACID PASTE IN THE TREATMENT 
OF EPITHELIOMA OF THE FACE.1 
By E. OLIVER BELT, M.D., 
OF WASHINGTON,'OrTT, 
LECTURER ON OPHTHALMOLOGY AND OTOLOGY, HOWARD UNIVERSITY 
AND OPHTHALMIC AND AURAL SURGEON TO FREEDMAN'S 
HOSPITAL. 
Epithelial carcinomata about the eyelids, brow, nose, 
and cheek are not uncommon. The clinical history of 
an ordinary case is about as follows : Beginning usually 
after middle life as a small, flat, wartlike growth, the new- 
formation appears very innocent at first, attracting but 
little attention, perhaps, until some years elapse, when it 
begins to ulcerate; the ulceration may heal temporarily, 
only to begin anew later on, when it suddenly begins to 
spread, attacking all kinds of tissue, sometimes destroying 
the eyeballs, nose, and bones of the face, the patient being 
in a most pitiable condition until relieved by death. 
Fortunately most of these cases are found in very old 
people, who die of natural causes before the growths 
give much annoyance. Occasionally, however, we see 
them in patients between forty and sixty years of age, 
with whom they may become a very serious trouble, and 
even destroy life years before the allotted time. By 
proper treatment before too much tissue is involved 
epithelioma of the face can unquestionably be eradicated, 
and yet we see now and then cases that have passed 
1 Read before the Medical Society of the District of Columbia, 
April 18, 1894. 2 
beyond all help of the physician or surgeon. Inquiry 
into the history of these hopeless cases will usually elicit 
the fact that the patient has allowed the trouble to reach 
this stage owing to the dread of having it cut out with 
the knife, which may have been recommended by his 
physician, or to escape this he has had applied some 
** cancer cure" that he has heard of or seen advertised, 
which has served only to irritate, and often rapidly 
extend the disease. Most authorities recommend ex- 
cision, and no one doubts its efficacy; but if the dread 
of the knife causes one to postpone treatment, it is well 
to try something unobjectionable to the patient and 
equally reliable; so we naturally turn our attention to 
local applications. We find many preparations recom- 
mended-among them may be named caustic potash, 
citrin ointment, Vienna paste, and pastes of chlorid of 
zinc, arsenic, and sulphuric acid, as well as the cautery. 
Of these some are very painful and harmful. Though 
the chlorid of zinc paste and the cautery seem to be the 
most frequently advised, my own experience leads me 
to call especial attention to the value of a paste made 
of sulphuric acid and charcoal from saffron, in about 
equal quantities by weight. It is by no means a new 
remedy, having been used years ago by Velpeau, Michel, 
and others; but little has been written about it, and I 
do not think it is used now as generally as its efficacy 
justifies. I first saw it used by Dr. J. J. Chisolm, while 
I was his assistant at the Presbyterian Eye and Ear 
Hospital, where it was frequently employed during the 
three years that I was connected with that institution, 
and in no case did I see an unfavorable result. 
In a recent letter from Dr. Chisolm he speaks of its 
use as follows: " I have been using carbo-sulphuric 
paste for thirty-five years in epithelial troubles of the 
face. It is one of the very old-time applications. I was 
taught its value as a student. The very fact that I con- 
tinue to use it is because I know nothing quite so good. 3 
If properly made with flowers of saffron, which makes 
the finest kind of carbon, it becomes a tenacious paste 
that will stick to a raw surface and become a part of the 
slough or dry scab, when slough and paste come off 
together, leaving a newly healed surface, which delights 
the heart of the surgeon. It is a first-rate application, 
which every one should know about. 
If the application is limited to the diseased tissue, it 
is not very painful unless the new growth is extensive. 
A few applications usually suffice, when a dry scab is 
formed, which peels 'off somewhat like a vaccination 
crust, leaving only a slight scar. 
A single case illustrates its value as compared with 
some other methods. About eighteen months ago Dr. 
J. came to me to have a small epithelial carcinoma re- 
moved from the side of his nose near the inner canthus 
of the right eye. He told me that he had recently re- 
turned from New York, where he had taken his wife to 
a special hospital to have a similar trouble removed from 
her face. She was kept in the institution at heavy ex- 
pense for three weeks, during which time caustics and 
poultices were applied. She was cured, but with a great 
deal of discomfort, loss of time, and heavy expense. 
Not being pleased with the treatment, the Doctor, whose 
own case was pronounced worse, came to me to have 
the sulphuric-acid paste applied. Two applications were 
made in three days, and about the tenth day the growth 
came away entire, the Doctor not having been kept 
from his practice more than a half-hour. I never advise 
this paste when the mucous membrane is involved. In 
all other cases that have not progressed too far, I like it 
as well as the knife, and think if physicians would use 
it with patients who postpone treatment from the dread 
of cutting, there would be few cases that reach the 
hopeless stage.