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Moments in Surgical History |

"Eiloides of the Neck in a Negro Girl"

Ira M. Rutkow, MD, MPH, DrPH
Arch Surg. 1998;133(6):683. doi:10-1001/pubs.Arch Surg.-ISSN-0004-0010-133-6-ssh0698.
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When John Collins Warren (1778-1856) authored Surgical Observations on Tumours, With Cases and Operations (1837) it seems unlikely that he could have realized his monograph would come to represent the first major written American effort in the future specialty area of surgical oncology. Divided into 14 sections (ie, "Epidermoid Tumours," "Dermoid Tumours," "Tumours of the Cellular Membrane," "Muscular Tumours," "Peristeal Tumours," "Osseous Tumours," "Tumours of the Glands," "Tumours of the Secreting Glands," "Tumours of the Testis," "Tumours of the Mucous Glands," "Tumours of the Vascular Texture," "Tumours of the Membranous Textures," "Encysted Tumours," and "Abdominal Tumours") plus a glossary of distinguishing characteristics of tumors (eg, "Eiloides; a morbid growth of the cutis, coiled or folded"), the work became especially prized because it contained 16 hand-colored plates of patients by the master American engraver and caricaturist David Claypoole Johnston (1799-1865). Although it was Warren's intent to eventually author an enlarged second edition, numerous other committments and his advancing age would keep him from doing so.

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In Warren's monograph, not all cases were related to malignant growths. In the chapter titled "Dermoid Tumours" he described an eiloides-shaped excrescence on a 15-year-old girl. Warren stated that no cause was known, "but a scrophulous habit seems to predispose to it." Astonished at its unsightly appearance, Warren "executed its removal." Eighteen months later, the young woman suffered a complete recurrence of the neoplasm, and "she died dropsical." Postmortem examination of her body revealed that "the lymphatic glands in the abdomen were greatly increased, forming large tumours throughout the cavity." Scrofula is an obsolescent and indefinite term for a constitutional state, occurring in the young, marked by a lack of "resisting power" of the body, predisposing to tuberculosis.

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