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October 27, 1906


JAMA. 1906;XLVII(17):1381-1382. doi:10.1001/jama.1906.02520170045007

Three recent articles from most competent men (Spiller and Frazier,1 Starr2 and Horsley3) emphasize the importance of surgical procedures—palliative and radical—in the treatment of cases of intracranial disease in which the symptoms are those of general brain pressure. One point especially brought out in these papers is the very great importance of early surgical interference when, as often exists in these cases, the optic nerve is involved. In his consideration of palliative surgical procedures, Horsley says: "In no case of optic neuritis (not, of course, of toxemic or anemic origin) should the process be allowed to continue after it has once been diagnosed, and if blindness results therefrom the responsibility is very heavy on any one who fails to advise such a simple procedure as opening the dura mater." Starr does not insist so emphatically on palliative operations, but he quotes encouraging cases. Spiller says that palliative

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