1915 Journal of the American Medical Association  
swelling. Into this incision a trocar was driven to the depth of about 1 inch. Into this cavity a tube containing radium was introduced. In all, the patient received eighteen such applications. The tube consisted of 10 mg. of radium bromid shielded by 1 mm. of lead. It was left in position at each application for four hours. The applications were made at first at intervals of three or four days, and subsequently at inter¬ vals of a week or more. The applications caused no pain and very little
more » ... n and very little local reaction. Within two weeks after the beginning of the treatment the tumor began to undergo a marked change characterized by a diminution throughout its entire extent. At the same time the induration gradually disappeared. February 10, the patient was dis¬ charged. At this time the tumor had almost entirely disappeared, and the parts had been restored to a condition approximately normal. The lobe of the ear, however, still remained slightly swollen and in¬ durated, a condition which has now completely disappeared. The cheek, the neck and the mastoid region present no trace of their previous condition. After her discharge from the hospital, the patient returned at intervals of about two to four weeks to receive Roentgen-ray or radium treatment. At the present time there is no indication of any recurrence, although treatment has been suspended for many months. The permanency of this recovery is, of course, not yet established. The facial palsy, which was un¬ questionably due to destruction of the facial nerve either by infiltra¬ tion or by pressure, has not receded. A puzzling feature of this case is presented by the condition of the right eye. Ophthalmologists to whom the patient has been referred have attributed the ocular condition to the presence of a retrobulbar mass pushing the eye forward and involving the sixth nerve. Whether or not this mass can be brought into relation, to the parotid tumor is a matter of speculation. The ocular condition has not been affected by the treatment SUMMARY A parotid tumor of seven years' duration, presenting cer¬ tain characteristic pathologic features, was treated for a period of six weeks by the insertion of radium into the tumor. The tumor disappeared, and after an interval of almost two years presents no recurrence. Medical School Inspection.-The North Carolina State Board of Health is actively advocating the medical inspection of schoolchildren in counties which do not have a whole-time county health officer, that a system in inspection arrangements may be perfected whereby the local county board of health and school officials may arrange with the state board for an inspection. The board furnishes competent experienced phy¬ sicians for this work, which is to be made a part of the unit system of the work to be performed by the state board in counties whose incomes do not, in the opinion of local public sentiment, justify the installation of a whole-time health officer.
doi:10.1001/jama.1915.02580250012003 fatcat:6ygmuixxyzh6pchhunexkg6mw4