188 THE MICROSCOPE. Dec. 



related the following incident as a sample of naivete' of some 

 medical practitioners when it comes to thejudicious and unpre- 

 judiced appreciation of the merits and achievements of the 

 microscope. 



A physician had sent him a vial of purulent fluid, which had 

 been gathered dur"ng the operation of a tumor of the breast, 

 with the request of examining the liquid microscopically in 

 order to determine whether the tumor was a carcinoma. 



Similar requests are, in our experience, by no means infre- 

 quent. Some surgeons, and not only obscure ones, will remove 

 with a curette a few cells of the mucous membrane of the uterus 

 and expect of a microscopist to make an examination of the re- 

 moved tissue and report whether the affection of the organ is of 

 a malignant or a benign nature. 



We have compared similar requests to the question of a stu- 

 dent (?) of anatomy, who asked the demonstrator, after remov- 

 ing apiece of a nerve-trunk, "Professor, what nerve is this?" 



Such occurrences, of which most histologists can cite parallel 

 cases, form one of the arguments for the necessity of a micro- 

 scopic training of all physicians, at least in a sufficient degree 

 that the possibilities and impossibilities of an histological diag- 

 nosis are properly understood and appreciated. 



While the very energetic use of a sharp curette may occasion- 

 ally remove pieces of tissue large enough to exhibit the charac- 

 teristic structure of a neoplasm so that a positive diagnosis can 

 be made, the cases in which the tissue removed with a curette 

 consists of a pell mell of tissue elements, without any indication 

 of its architecture, are so predominating that the diagnosis based 

 upon its examination is practically worthless. Such examina- 

 tion-, although they may in rare cases furnish presumptive 

 evidence which, in connection with the clinical manifestations 

 of disease, may lead the surgeon to arrive at a conclusion as to 

 the necessary therapeutic procedure, are apt to bring microscopy 

 into discredit. The removal by the curette of an abundance of 

 epithelial cells or young connective tissue cells may lead a 

 microscopist to suspect a carcinoma or a sarcoma, but a surgeon 

 has no right to perform a radical operation upon such a mere 

 suspicion, when it is an easy matter for him to remove a wedge- 

 shaped piece of tissue large enough to make an exact histologi- 

 cal diagnosis. 



