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November 9, 1889

Tenth International Medical Congress.

JAMA. 1889;XIII(19):672. doi:10.1001/jama.1889.02401150022005

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cerning only the fragment submitted to him, not of the disease itself, unless he discovers in this fragment positive indications of malignancy. The examination must not be limited to a single section, but should embrace, in fine sections, the entire fragment submitted, unless the diagnosis of malignancy is with certainty sooner determined. If necessary, the careful removal and microscopic examination of fragments should be several times repeated, unless in the meantime clinical symptoms, which with our present knowledge of symptomatology are irreconcilable with benignity, establish with certainty the malignant character of the neoplasm. In such cases an otherwise indicated radical operation should not be delayed for microscopic confirmation of the diagnosis."

What, then, are the clinical symptoms which will aid so substantially in the diagnosis of certain cases? These have not yet received the detailed consideration which the gravity of the subject demands, but the Sammelforschung contains data which materially

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