judgments. Except at large medical centers, there were too few cases of any one kind to afford such opportunity for study. By combining cases from the country as a whole, Major Callender observed, "It will be possible to obtain considerable numbers of cases and specimens in a much shorter time."
The Registry was not intended to replace the local pathologist and would "never serve as a diagnostic laboratory." Rather, it was to be "a clearing house in pathology to which will be sent cases already diagnosed and the obscure cases about which more can be learned by obtaining the opinions of several pathologists. In addition, by sending 'follow-up' letters to the physician registering cases, the Registry will be a means of helpful stimulation."
The success attained by the three registries already in operation when the American Registry was formed, had "been obtained in spite of a minimum of publicity effort because there has been insufficient personnel at the Army Medical Museum to conduct larger collections. As the registries have become better known, the 'follow-up' work alone is more than can be handled adequately in the time of the Museum personnel available for it."
"The expense of these registries has thus far been borne entirely by the Museum, whose entire budget, inclusive of all personnel and upkeep of plant, is about $30,000. The expense for materials and equipment for the proposed registry can be handled by the Museum," he added, "but it is necessary to have additional help in the form of professional, clerical and technical personnel."
Other activities of the Museum personnel included the handling of the tissues and histories of all cases of tumor or suspected tumor in the Army, and the review of the protocols of all Army necropsies, numbering about 800 a year. 4[1] With a staff of but one medical officer, two medical technicians, one stenographer, and one typist, it was obvious that additional help must be had if the registries were to realize their full potential. Another obstacle to securing continuity of policy was the fact that the officer personnel on duty at the Museum was shifted every 4 years, usually, and in many cases after even shorter periods.
In his outline of the operations and potentialities of the American Registry of Pathology, Major Callender paid particular attention to the possibilities offered by the registry in the earlier diagnosis of malignant growths. "It is generally acknowledged by pathologists," he said in his 1930 outline," that many neoPlasms are difficult to diagnose. * * * The earliest changes which signify malignancy are not sharply defined. In fact, there is serious doubt if we know by sight the earliest malignant changes in any tissue. Unless cases are followed up we cannot
- ↑ 4 Army Regulations No. 40-410, 18 January 1922. paragraphs 19. 20.
