Malignant disease of the throat and nose / by David Newman.

  • Newman, David, 1853-1924
Date:
1892
Catalogue details

Licence: Public Domain Mark

Credit: Malignant disease of the throat and nose / by David Newman. Source: Wellcome Collection.

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    protracted slight irritation is likely to determine the site of the primary growth. This point has been well illustrated by the cases m which the points of selection were (1) the upper part of the oesophagus, where the tube becomes suddenly narrowed behind the cricoid cartilage, and where, during deglutition, the bolus of food is moulded into form to pass down the gullet; (2) at the point where the oesophagus passes behind the bifurcation of the trachea; and (3) where it penetrates the diaphragm, in all of which situations there is more likely to be obstruction to the passage of large morsels of food. Again, it has been observed that epithelioma of the oesophagus may follow upon simple stenosis, or upon an old cicatrix, just as we may have malignant disease planted on an old syphilitic cicatrix on the tongue, or a burn of the skin. In many of the cases which have come under my notice, the patients have told me that for a considerable time, sometimes for years, before they experienced any difficulty in swallowing, they were troubled with indigestion and acidity, and had been falling off in general health. In instances where these symp- toms existed for only weeks or months, the possibility is that the malignant disease was present from the onset, but when symptoms of gastric and oesophageal irritation have been present for years previous to any definite obstruction to swallowing, one cannot but seek an etiological relationship between the chronic inflammatory lesion and the carcinomatous growth. Is it likely that the tumour in these cases, as in the more acute cases, existed from the beginmng of the illness ? Passing now to the consideration of the pathology of the carcinomata of the oesophagus, we have already seen that there are certain points of selection; but while this is so, any part of the tube may be attacked. When the disease is, as is usually the case, a squamous-celled epithelioma, the histological structure and mode of growth closely resemble cancer of the lip, or of the larynx. A small, raised, warty, or nodular tumour appears.
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