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LU~G C~NCE-~ I~ THE ~[~TI~ CE~-TU~~ 4O3 cancer, and his report equalled in thoroughness any of the contemporary studies published abroad. In addition to an excellent exposition of physical signs, there was a review of the extra-thoracic manifestations resulting from involvement of the cervical sympathetic nodes, brachial plexus, and superior vena cava. Storer, in 1851, described a case from the Massachu- setts General Hospital and emphasized that diagnostic clinical features had occurred very late in the course of the disease. A case report by Lehlbach, in 1870, in the Transactio~s of the Medical Society of New Jersey, was of unusual interest, historically, because microscopic examination of the sputum was mentioned, casually, as if it had been a routine procedure. Francis Delafield, at the time pathologist at Roosevelt Hospital, New York City, kept a special notebook with the title, " Case reports of turnouts of the lung, 1868-1888," in which were recorded in his own handwriting protocols of cases of primary cancer of the Irreg. In 1876, Loomis discussed lung cancer in Lectures o~t Diseases of the Respiratory Organs, Erea.rt tznd I(.idneys and tried to differentiate between primary and secondary lesions. The extent of accumulated kno~vledge on lung cancer became very evident in France and Germany in the 1870's. Jaccoud, who had previ- ously presented many case reports in various journals, contributed an excellent article in 1872 in his Trai~d de pc~thologie interne. In the same year Eppinger reported an exhaustive statistical study of carcinoma from the Prague Pathological Institute in the Viertel]ahrschri# fiir die prak- tische Heilk~,de. The incidence of lung cancer among total cancers was found significantly high, but the differentiation between primary and secondary involvement was not sufficiently clear despite the evident interest in histogenesis and histological structure. An intensive clinical discussion appeared in 1873 in the doctoral thesis, Du cancer pulmomzire, by Camo-Abdon. It was noted in this thesis that malignant proliferation of bronchial epithelium occurred in various forms including fusiform cells. In a dissertation at Wiirzburg, in 1874, Schottelius gave a vivid description of the routes of lymphangitic spread throughout the lung from the primary lesion. Ziemsse~ds C3,dopedic~ o~ the Prc~ctice of Medi- cine, 1875, had a chapter on pulmonary neoplasms by Hertz. Lataste, in 1875, reported an interesting case in the Bulletins de lc~ Soci~td anatomique de Paris with a detailed discussion of the histologic aspects of malignant epithelial changes. During the last quarter of the 19th century the literature began to include an increasing number of detailed histological studies. In the early T109782634