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October 8, 1887


JAMA. 1887;IX(15):478-479. doi:10.1001/jama.1887.02400140030009

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In June, 1885, I excised a sebaceous tumor which had been located mostly in the space bounded by the angle of the jaw in front, and the lobe of the ear above. The tumor had lain partly over the parotid gland in front of the lobe of the ear. I had expected to be able easily to lift the tumor out of its bed after making a free incision; but I found it very tightly bound down and intimately connected by areolar tissue—with the surrounding tissues—making a careful dissection necessary to dislodge it. The operation was very bloody and my assistance was indifferent, but the tumor was ultimately dislodged. The wound seemed to be healing kindly until one day my patient informed me that at times a gush of fluid flowed from what was a small remnant of the wound. I became aware that I had a salivary fistula to

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