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JAMA. 1905;XLIV(11):868-870. doi:10.1001/jama.1905.92500380032001e.
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Dr. Theodore Diller, Pittsburg, Pa., said that he recently recorded a case in which the bone was eroded over the seat of the tumor. At the time of the operation the bone was found to be very thin, and there was evidence of protrusion over the site of the tumor as in Dr. Keen's case. The bone was eroded, quite thin, necrotic and easily cut away. Dr. Diller's colleague, Dr. McKennan, had a case last winter in which there was also a protrusion over the site of the tumor. But in his case the bone, instead of being thin and eroded, was greatly thickened. Dr. Diller stated that Sir Victor Horsley does not suture the dura mater, as he considers it time consuming and unnecessary, and asked what is Dr. Keen's practice in this particular. He also referred to a case of brain tumor operated on by Dr. R. W. Stewart recently. The patient exhibited the general symptoms of brain tumor, severe headache and a high degree of optic neuritis with several generalized convulsions besides three symptoms which, taken together, seemed to point to the frontal lobe:


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